EMBASE Cardiac Update AutoAlert: EPICORE Cardiac Surgery Blogger2

Total documents retrieved: 82

Results Generated From:
Embase <1980 to 2022 Week 32>
Embase Weekly Updates (updates since 2022-08-05)

<1>
Accession Number
2014359609
Title
Stenting techniques for coronary bifurcation disease: a systematic review
and network meta-analysis demonstrates superiority of double-kissing crush
in complex lesions.
Source
Clinical Research in Cardiology. 111(7) (pp 761-775), 2022. Date of
Publication: July 2022.
Author
Wang R.; Ding Y.; Yang J.; Wang K.; Gao W.; Fang Z.; Zhou Y.; Ge H.
Institution
(Wang, Ding, Yang, Wang, Zhou, Ge) Department of Cardiology, Beijing
Anzhen Hospital, Capital Medical University, Beijing 100029, China
(Gao) Department of Cardiology, Bayannaoer City Hospital, Inner Mongolia
015002, China
(Fang) Department of Cardiology, Beijing Daxing District People's
Hospital, Capital Medical University Daxing Teaching Hospital, Capital
Medical University, Beijing 102699, China
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Objective: This study was aimed to compare different stenting techniques
for coronary bifurcation disease (CBD). <br/>Background(s): Percutaneous
coronary intervention (PCI) remains controversial for CBD; over the years,
several stent techniques for bifurcation lesions have been used. Current
guidelines recommend a provisional single-stent strategy as the preferred
method for coronary artery bifurcation lesions. However, several
randomized controlled trials (RCT) indicated that two-stent techniques
showed better clinical outcomes. <br/>Method(s): We systematically
searched Embase, PubMed, and Web of Science to include RCTs. The primary
endpoint was the major adverse cardiovascular event (MACE). Secondary
outcomes were cardiac death, myocardial infarction (MI), target-lesion or
target-vessel revascularization (TLR or TVR), and definite or probable
stent thrombosis (ST). Finally, we used 26 RCTs and a total of 7257
individuals were randomly assigned to one of the 6 stent techniques and
included in this network meta-analysis. <br/>Result(s): In our network
meta-analysis, double-kissing (DK) crush was significantly more superior
to other 5 stent techniques in MACEs: OR vs. provisional 0.40 (95% CI
0.28-0.55); vs. culotte 0.40 (95% CI 0.26-0.60). DK crush ranked the most
effective treatment for MACE (100%), MI (75%), ST (83%), and TLR (100%) in
the rank probabilities analysis. In patients with complex bifurcation
lesion defined by DEFINITION criteria, DK crush was notably more
efficacious than provisional, culotte, and T-stenting/T-stenting and
protrusion (TAP) in MACEs (OR vs. provisional 0.26, 95% CI 0.13-0.52) and
TLR (OR vs. provisional 0.24, 95% CI 0.10-0.58). <br/>Conclusion(s):
Compared with other stenting techniques, DK crush had a lower incidence of
MACEs in CBD. DK crush was significantly associated with a lower rate of
MACEs in patients with complex bifurcation lesions defined by the
DEFINITION criterion. Graphical abstract: [Figure not available: see
fulltext.]<br/>Copyright &#xa9; 2021, The Author(s).

<2>
Accession Number
638574504
Title
Antiplatelet agents and anticoagulants for hypertension.
Source
Cochrane Database of Systematic Reviews. 2022(7) (no pagination), 2022.
Article Number: CD003186. Date of Publication: 28 Jul 2022.
Author
Shantsila E.; Koziel-Siolkowska M.; Lip G.Y.H.
Institution
(Shantsila, Koziel-Siolkowska, Lip) Liverpool Centre for Cardiovascular
Science, University of Liverpool and Liverpool Heart & Chest Hospital,
Liverpool, United Kingdom
(Koziel-Siolkowska) 1st Department of Cardiology and Angiology, Silesian
Centre for Heart Diseases, Zabrze, Poland
Publisher
John Wiley and Sons Ltd
Abstract
Background: The main complications of elevated systemic blood pressure
(BP), coronary heart disease, ischaemic stroke, and peripheral vascular
disease, are related to thrombosis rather than haemorrhage. Therefore, it
is important to investigate if antithrombotic therapy may be useful in
preventing thrombosis-related complications in patients with elevated BP.
<br/>Objective(s): To conduct a systematic review of the role of
antiplatelet therapy and anticoagulation in patients with elevated BP,
including elevations in systolic or diastolic BP alone or together. To
assess the effects of antiplatelet agents on total deaths or major
thrombotic events or both in these patients versus placebo or other active
treatment. To assess the effects of oral anticoagulants on total deaths or
major thromboembolic events or both in these patients versus placebo or
other active treatment. <br/>Search Method(s): The Cochrane Hypertension
Information Specialist searched the following databases for randomised
controlled trials (RCTs) up to January 2021: the Cochrane Hypertension
Specialised Register, the Cochrane Central Register of Controlled Trials
(CENTRAL; 2020, Issue 12), Ovid MEDLINE (from 1946), and Ovid Embase (from
1974). The World Health Organization International Clinical Trials
Registry Platform and the US National Institutes of Health Ongoing Trials
Register (ClinicalTrials.gov) were searched for ongoing trials.
<br/>Selection Criteria: RCTs in patients with elevated BP were included
if they were >= 3 months in duration and compared antithrombotic therapy
with control or other active treatment. <br/>Data Collection and Analysis:
Two review authors independently extracted data for inclusion criteria,
our prespecified outcomes, and sources of bias. They assessed the risks
and benefits of antiplatelet agents and anticoagulants by calculating odds
ratios (OR), accompanied by the 95% confidence intervals (CI). They
assessed risks of bias and applied GRADE criteria. <br/>Main Result(s):
Six trials (61,015 patients) met the inclusion criteria and were included
in this review. Four trials were primary prevention (41,695 patients; HOT,
JPAD, JPPP, and TPT), and two secondary prevention (19,320 patients,
CAPRIE and Huynh). Four trials (HOT, JPAD, JPPP, and TPT) were
placebo-controlled and two studies (CAPRIE and Huynh) included active
comparators. Four studies compared acetylsalicylic acid (ASA) versus
placebo and found no evidence of a difference for all-cause mortality (OR
0.97, 95% CI 0.87 to 1.08; 3 studies, 35,794 participants; low-certainty
evidence). We found no evidence of a difference for cardiovascular
mortality (OR 0.98, 95% CI 0.82 to 1.17; 3 studies, 35,794 participants;
low-certainty evidence). ASA reduced the risk of all non-fatal
cardiovascular events (OR 0.63, 95% CI 0.45 to 0.87; 1 study (missing data
in 3 studies), 2540 participants; low-certainty evidence) and the risk of
all cardiovascular events (OR 0.86, 95% CI 0.77 to 0.96; 3 studies, 35,794
participants; low-certainty evidence). ASA increased the risk of major
bleeding events (OR 1.77, 95% CI 1.34 to 2.32; 2 studies, 21,330
participants; high-certainty evidence). One study (CAPRIE; ASA versus
clopidogrel) included patients diagnosed with hypertension (mean age 62.5
years, 72% males, 95% Caucasians, mean follow-up: 1.91 years). It showed
no evidence of a difference for all-cause mortality (OR 1.02, 95% CI 0.91
to 1.15; 1 study, 19,143 participants; high-certainty evidence) and for
cardiovascular mortality (OR 1.08, 95% CI 0.94 to 1.26; 1 study, 19,143
participants; high-certainty evidence). ASA probably reduced the risk of
non-fatal cardiovascular events (OR 1.10, 95% CI 1.00 to 1.22; 1 study,
19,143 participants; high-certainty evidence) and the risk of all
cardiovascular events (OR 1.08, 95% CI 1.00 to 1.17; 1 study, 19,143
participants; high-certainty evidence) when compared to clopidogrel.
Clopidogrel increased the risk of major bleeding events when compared to
ASA (OR 1.35, 95% CI 1.14 to 1.61; 1 study, 19,143 participants;
high-certainty evidence). In one study (Huynh; ASA verus warfarin)
patients with unstable angina or non-ST-segment elevation myocardial
infarction, with prior coronary artery bypass grafting (CABG) were
included (mean age 68 years, 79.8% males, mean follow-up: 1.1 year). There
was no evidence of a difference for all-cause mortality (OR 0.98, 95% CI
0.06 to 16.12; 1 study, 91 participants; low-certainty evidence).
Cardiovascular mortality, non-fatal cardiovascular events, and all
cardiovascular events were not available. There was no evidence of a
difference for major bleeding events (OR 0.13, 95% CI 0.01 to 2.60; 1
study, 91 participants; low-certainty evidence). Authors' conclusions:
There is no evidence that antiplatelet therapy modifies mortality in
patients with elevated BP for primary prevention. ASA reduced the risk of
cardiovascular events and increased the risk of major bleeding events.
Antiplatelet therapy with ASA probably reduces the risk of non-fatal and
all cardiovascular events when compared to clopidogrel. Clopidogrel
increases the risk of major bleeding events compared to ASA in patients
with elevated BP for secondary prevention. There is no evidence that
warfarin modifies mortality in patients with elevated BP for secondary
prevention. The benefits and harms of the newer drugs glycoprotein
IIb/IIIa inhibitors, clopidogrel, prasugrel, ticagrelor, and non-vitamin K
antagonist oral anticoagulants for patients with high BP have not been
studied in clinical trials. Further RCTs of antithrombotic therapy
including newer agents and complete documentation of all benefits and
harms are required in patients with elevated BP.<br/>Copyright &#xa9; 2022
The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.

<3>
Accession Number
2019013771
Title
Association between sarcoidosis and cardiovascular Outcomes: A systematic
review and Meta-analysis.
Source
IJC Heart and Vasculature. 41 (no pagination), 2022. Article Number:
101073. Date of Publication: August 2022.
Author
Jaiswal V.; Peng Ang S.; Sarfraz Z.; Butey S.; Vinod Khandait H.; Song D.;
Ee Chia J.; Maroo D.; Hanif M.; Ghanim M.; Chand R.; Biswas M.
Institution
(Jaiswal) AMA School Of Medicine, Makati, Philippines
(Peng Ang) Department of Internal Medicine, Rutgers Health/Community
Medical Center, NJ, United States
(Sarfraz) Fatima Jinnah Medical University, Lahore, Pakistan
(Butey) Indira Gandhi Government Medical College, Nagpur, India
(Vinod Khandait, Chand) Department of Internal Medicine, Trinitas Regional
Medical Center, Elizabeth, NJ, United States
(Song) Department of Internal Medicine, Icahn School of Medicine at Mount
Sinai Hospital, NY, United States
(Ee Chia) School of Medicine, International Medical University, Kuala
Lumpur, Malaysia
(Maroo) Maulana Azad Medical College, New Delhi, India
(Hanif) Department of Internal Medicine, Suny Upstate Medical University,
NY, United States
(Ghanim) Henry Ford Healthcare System, Detroit, MI, United States
(Biswas) General Cardiology and Advanced Heart Failure, Wellspan
Cardiology, Lancaster, PA, United States
Publisher
Elsevier Ireland Ltd
Abstract
Background: Sarcoidosis is a chronic inflammatory disorder of unknown
etiology associated with high morbidity and mortality. Its association
with cardiovascular outcomes is under-documented. <br/>Aim(s): The aim of
this study was to assess the adverse cardiovascular outcomes in patients
with sarcoidosis compared with that of non-sarcoidosis. Methodology:
Online databases including PubMed, Embase and Scopus were queried from
inception until March 2022. The outcomes assessed included all-cause
mortality (ACM) and incidence of ventricular tachycardia (VT), heart
failure (HF) and atrial arrhythmias (AA). <br/>Result(s): A total of 6
studies with 22,539,096 participants (42,763 Sarcoidosis, 22,496,354
Non-Sarcoidosis) were included in this analysis. The pooled prevalence of
sarcoidosis was 13.1% (95% CI 1% to 70%). The overall mean age was 47
years. The most common comorbidities were hypertension (12.7% vs 12.5%),
and diabetes mellitus (5.5% vs 4%) respectively. The pooled analysis of
primary endpoints showed that all-cause mortality (RR, 2.08; 95% CI: 1.17
to 3.08; p = 0.01) was significantly increased in sarcoidosis patients.
The pooled analysis of secondary endpoints showed that the incidence of VT
(RR, 15.3; 95% CI: 5.39 to 43.42); p < 0.001), HF (RR, 4.96; 95% CI: 2.02
to 12.14; p < 0.001) and AA (RR, 2.55; 95% CI: 1.47 to 4.44); p = 0.01)
were significantly higher with sarcoidosis respectively compared to
non-sarcoidosis. <br/>Conclusion(s): Incidence of VT, HF and AA was
significantly higher in patients with CS. Clinicians should be aware of
these adverse cardiovascular events associated with
sarcoidosis.<br/>Copyright &#xa9; 2022 The Authors

<4>
Accession Number
2016662722
Title
Target Low-Density Lipoprotein-Cholesterol and Secondary Prevention for
Patients with Acute Myocardial Infarction: A Korean Nationwide Cohort
Study.
Source
Journal of Clinical Medicine. 11(9) (no pagination), 2022. Article Number:
2650. Date of Publication: May-1 2022.
Author
Kim J.H.; Cha J.-J.; Lim S.; An J.; Kim M.-N.; Hong S.J.; Joo H.J.; Park
J.H.; Yu C.W.; Lim D.-S.; Byeon K.; Kim S.-W.; Shin E.-S.; Cha K.S.; Chae
J.K.; Ahn Y.; Jeong M.H.; Ahn T.H.
Institution
(Kim, Cha, Lim, Kim, Hong, Joo, Park, Yu, Lim) Department of Cardiology,
Cardiovascular Center, Korea University Anam Hospital, Korea University
College of Medicine, Seoul 02841, South Korea
(An) Department of Pathology, Korea University Anam Hospital, Korea
University College of Medicine, Seoul 02841, South Korea
(Byeon, Kim, Ahn) Department of Cardiology, Heart and Brain Institute,
Chung-Ang University Gwang-Myeong Hospital, Chung-Ang University College
of Medicine, Gwangmyeong-si 14353, South Korea
(Shin) Division of Cardiology, Department of Internal Medicine, Ulsan
University Hospital, University of Ulsan College of Medicine, Ulsan 44033,
South Korea
(Cha) Division of Cardiology, Department of Internal Medicine, Pusan
National University Hospital, Busan 49241, South Korea
(Chae) Division of Cardiology, Department of Internal Medicine, Chonbuk
National University Medical School, Jeonju 54907, South Korea
(Ahn, Jeong) Division of Cardiology, Department of Internal Medicine,
Chonnam National University Hospital, Chonnam National University Medical
School, Gwangju 61469, South Korea
Publisher
MDPI
Abstract
Although lowering low-density lipoprotein cholesterol (LDL-C) levels
following acute myocardial infarction (MI) is the cornerstone of secondary
prevention, the attainment of recommended LDL-C goals remains suboptimal
in real-world practice. We sought to investigate recurrent adverse events
in post-MI patients. From the Korea Acute Myocardial Infarction-National
Institutes of Health registry, a total of 5049 patients with both
measurements of plasma LDL-C levels at index admission and at the one-year
follow-up visit were identified. Patients who achieved an LDL-C reduction
>= 50% from the index MI and an LDL-C level <= 70 mg/dL at follow-up were
classified as target LDL-C achievers. The primary endpoint was a two-year
major adverse cardiac and cere-brovascular event (MACCE), including
cardiovascular mortality, recurrent MI, and ischemic stroke. Among the
5049 patients, 1114 (22.1%) patients achieved the target LDL-C level.
During a median follow-up of 2.1 years, target LDL-C achievers showed a
significantly lower incidence (2.2% vs. 3.5%, log-rank p = 0.022) and a
reduced adjusted hazard of MACCE (0.63; p = 0.041). In patients with acute
MI, achieving a target LDL-C level was associated with a lower incidence
and a reduced hazard of recurrent clinical events. These results highlight
the need to improve current practices for managing LDL-C levels in
real-world settings.<br/>Copyright &#xa9; 2022 by the authors. Licensee
MDPI, Basel, Switzerland.

<5>
Accession Number
2014101240
Title
Stent evaluation by coronary computed tomography angiography: A comparison
between Iopamidol-370 and Ioversol-320 hypo-osmolar iodine concentration
contrasts.
Source
British Journal of Radiology. 93(1115) (no pagination), 2020. Article
Number: 20200078. Date of Publication: 01 Nov 2020.
Author
Garcia A.M.; Assuncao A.N.; Dantas R.N.; Parga J.R.; Ganem F.
Institution
(Garcia, Assuncao, Dantas, Parga, Ganem) Sirio-Libanes Hospital, SP, Sao
Paulo, Brazil
Publisher
British Institute of Radiology
Abstract
Objective: Qualitative and quantitative image analysis between
Iopamidol-370 and Ioversol-320 in stents' evaluation by coronary computed
tomography angiography (CTA). <br/>Method(s): Sixty-five patients with
low-risk stable angina undergoing stent follow-up with coronary CTA were
assigned to Iopamidol I-370 (n = 33) or Ioversol I-320 (n = 32) in this
prospective, double-blind, non-inferiority, randomized trial. Stent lumen
image quality was graded by 5-point Likert Scale. Lumen mean attenuation
was measured at native coronary segments: pre-stent, post-stent, distal
segments and at coronary plaques. Lumen attenuation increase (LAI) ratio
was calculated for all stents. Heart rate (HR) variation, premature heart
beats (PHB), heat sensation (HS), blooming and beam hardening were also
assessed. <br/>Result(s): Image quality was similar between groups, with
no significant difference (Likert score 4.48 +/- 0.75 vs 4.54 +/- 0.65, p
= 0.5). There were similarities in LAI ratio between I-370 and I-320 (0.39
+/- 0.42 vs 0.48 +/- 0.44 HU, p = 0.08). Regarding lumen mean attenuation
at native coronary segments, a significant difference was observed, with
I-320 presenting lower values, including contrast mean attenuation in
distal segments. After statistical multivariate analysis, three variables
correlated with stent image quality: 1) stent diameter, 2) HR variation
and 3) stent lumen LAI ratio. <br/>Conclusion(s): There was no significant
difference between Iopamidol-370 mgI ml^-1 and Ioversol-320 mgI
ml^-1 contrasts regarding overall stent lumen image quality,
which was mainly influenced by stent diameter, HR and LAI
ratio.<br/>Copyright &#xa9; 2020 British Institute of Radiology. All
rights reserved.

<6>
Accession Number
2018851546
Title
Effect of bariatric surgery on long-term cardiovascular outcomes: a
systematic review and meta-analysis of population-based cohort studies.
Source
Surgery for Obesity and Related Diseases. 18(8) (pp 1074-1086), 2022. Date
of Publication: August 2022.
Author
Tang B.; Zhang Y.; Wang Y.; Wang X.; An Z.; Yu X.
Institution
(Tang, Zhang, An, Yu) Department of Pharmacy, Beijing Chao-Yang Hospital,
Capital Medical University, Beijing, China
(Wang) Department of Pharmacy, Beijing An-Zhen Hospital, Capital Medical
University, Beijing, China
(Wang) Department of Pharmacy, Beijing Obstetrics and Gynecology Hospital,
Capital Medical University, Beijing, China
Publisher
Elsevier Inc.
Abstract
This meta-analysis aimed to compare the effects of bariatric surgery and
nonsurgery on cardiovascular outcomes in patients with obesity. A
systematic literature search of the Medline (via PubMed), Embase, and
Cochrane Central Register of Controlled Trials databases was performed
until August 18th, 2021. Population-based cohort studies comparing
long-term cardiovascular outcomes for patients with obesity undergoing
bariatric surgery or not were included. A meta-analysis of relative risks
(RRs) was performed for all outcomes. We conducted subgroup analyses and
meta-regression to explore sources of heterogeneity and the stability of
the results. Twenty-one population-based cohort studies involving
2,857,016 participants were identified. The major adverse cardiovascular
event (MACE) RR in the bariatric surgery group was .53 (95% confidence
interval [CI] = .45-.62, P < .001) relative to the nonsurgical group.
Relative to the nonsurgical group, the risk of myocardial infarction (MI)
(RR = .40, 95% CI = .30-.52, P < .001), stroke (RR = .60, 95% CI =
.46-.79, P < .001), cardiovascular death (RR = .43, 95% CI = .35-.54, P <
.001), and all-cause death (RR = .44, 95% CI = .32-.59, P < .001) was
significantly reduced for patients who underwent bariatric surgery. In
subgroup analyses, as the proportion of patients with diabetes mellitus
increased, lower RRs for MACE, MI, and stroke were observed in the surgery
group relative to the nonsurgical group. The decreased risk of MACE was
also observed in the subgroup with median follow-up duration >=5
years.Bariatric surgery improves cardiovascular outcomes in patients with
obesity, especially providing long-term benefits, and this effect is more
pronounced in patients with comorbid diabetes.<br/>Copyright &#xa9; 2022
American Society for Metabolic and Bariatric Surgery

<7>
Accession Number
2019632451
Title
Direct oral anticoagulants or vitamin K antagonists after TAVR: A
systematic review and meta-analysis.
Source
International Journal of Cardiology. (no pagination), 2022. Date of
Publication: 2022.
Author
Oliveri F.; Montalto C.; Tua L.; Lanzillo G.; Compagnoni S.; Fasolino A.;
Gentile F.R.; Ferlini M.; Pepe A.; Oltrona Visconti L.; Bongiorno A.;
Leonardi S.
Institution
(Oliveri, Tua, Lanzillo, Compagnoni, Fasolino, Gentile, Ferlini, Pepe,
Bongiorno, Leonardi) Department of Molecular Medicine, University of
Pavia, Pavia, Italy
(Montalto) Interventional Cardiology, De Gasperis Cardio Center, Niguarda
Hospital, Milan, Italy
(Oltrona Visconti, Leonardi) Division of Cardiology, Fondazione IRCCS
Policlinico San Matteo, Pavia, Italy
Publisher
Elsevier Ireland Ltd
Abstract
Background: Several patients undergoing transcatheter aortic valve
replacement (TAVR) also require oral anticoagulation (OAC) for atrial
fibrillation (AF) or deep vein thromboembolism. However, the optimal type
of OAC strategy (direct oral anticoagulants, DOACs, or vitamin K
antagonists, VKA) is still unclear in this setting. <br/>Method(s): We
performed systematic literature research and meta-analysis in PubMed,
Medline, and EMBASE databases for studies reporting either all-cause
mortality, major/life-threatening bleeding or stroke events.
<br/>Result(s): Ten observational studies and two randomized controlled
trials (RCTs) including a total of 29,485 patients were eligible for
inclusion. Compared to VKA, DOACs use after TAVR was associated with a
modest but significantly lower rates of all-cause mortality (RR 0.90; 95%
CI: 0.81-0.99, p-value 0.04) with results mainly driven by observational
studies. Cardiovascular mortality (RR 1.03; 95% CI: 0.81-1.30; p-value
0.84), total stroke events (RR 0.97; 95% CI: 0.76-1.23, p-value 0.79),
major/life-threatening bleeding (RR 0.93; 95% CI: 0.72-1.21, p-value 0.61)
and minor bleeding (RR 0.96; 95% CI: 0.74-1.23; p-value 0.72) were similar
between VKA and DOACs. <br/>Conclusion(s): Considering the totality of
available evidence, in patients who underwent TAVR with a concomitant
indication for OAC, DOACs-based strategy is an effective and safe
anticoagulation strategy compared to VKA.<br/>Copyright &#xa9; 2022
Elsevier B.V.

<8>
Accession Number
2013676446
Title
Pregnancy-related acute myocardial infarction: a review of the recent
literature.
Source
Clinical Research in Cardiology. 111(7) (pp 723-731), 2022. Date of
Publication: July 2022.
Author
Merlo A.C.; Rosa G.M.; Porto I.
Institution
(Merlo, Rosa, Porto) Department of Internal Medicine and Medical
Specialties (DIMI), Chair of Cardiovascular Diseases, University of Genoa,
Genoa, Italy
(Rosa, Porto) Cardiology Unit, DICATOV-Cardiothoracic and Vascular
Department, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Pregnancy-related acute myocardial infarction is a rare and potentially
life-threatening cardiovascular event, the incidence of which is growing
due to the heightened prevalence of several risk factors, including
increased maternal age. Its main aetiology is spontaneous coronary artery
dissection, which particularly occurs in pregnancy and may engender severe
clinical scenarios. Therefore, despite frequently atypical and deceptive
presentations, early recognition of such a dangerous complication of
gestation is paramount. Notwithstanding diagnostic and therapeutic
improvements, pregnancy-related acute myocardial infarction often carries
unfavourable outcomes, as emergent management is difficult owing to
significant limitations in the use of ionising radiation-e.g. during
coronary angiography, potentially harmful to the foetus even at low doses.
Notably, however, maternal mortality has steadily decreased in recent
decades, indicating enhanced awareness and major medical advances in this
field. In our paper, we review the recent literature on pregnancy-related
acute myocardial infarction and highlight the key points in its
management.<br/>Copyright &#xa9; 2021, The Author(s).

<9>
Accession Number
2015318072
Title
Left main coronary artery compression by dilated pulmonary artery in
pulmonary arterial hypertension: a systematic review and meta-analysis.
Source
Clinical Research in Cardiology. 111(7) (pp 816-826), 2022. Date of
Publication: July 2022.
Author
Badea R.; Dorobantu D.M.; Sharabiani M.T.A.; Predescu L.M.; Coman I.M.;
Ginghina C.
Institution
(Badea, Predescu, Coman, Ginghina) Cardiology Department, Carol Davila
University of Medicine and Pharmacy, Soseaua Fundeni nr. 258, Bucharest,
Romania
(Dorobantu) Children's Health and Exercise Research Centre (CHERC),
University of Exeter, Exeter, United Kingdom
(Dorobantu) School of Population Health Sciences, University of Bristol,
Bristol, United Kingdom
(Sharabiani) Department of Primary Care and Public Health, School of
Public Health, Imperial College of London, London, United Kingdom
(Predescu, Coman, Ginghina) Cardiology Department, Prof. Dr. C. C. Iliescu
Emergency Institute for Cardiovascular Diseases, Bucharest, Romania
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Objective: Pulmonary arterial hypertension (PAH) can lead to left main
coronary artery compression (LMCo), but data on the impact, screening and
treatment are limited. A meta-analysis of LMCo cases could fill the
knowledge gaps in this topic. <br/>Method(s): Electronic databases were
searched for all LMCo/PAH studies, abstracts and case reports including
pulmonary artery (PA) size. Restricted maximum likelihood meta-analysis
was used to evaluate LMCo-associated factors. Specificity, sensitivity and
accuracy of PA size thresholds for diagnosis of LMCo were calculated.
Treatment options and outcomes were summarized. <br/>Result(s): A total of
five case-control cohorts and 64 case reports/series (196 LMCo and 438
controls) were included. LMCo cases had higher PA diameter (Hedge's g 1.46
[1.09; 1.82]), PA/aorta ratio (Hedge's g 1.1 [0.64; 1.55]) and probability
of CHD (log odds-ratio 1.22 [0.54; 1.9]) compared to non-LMCo, but not PA
pressure or vascular resistance. A 40 mm cut-off for the PA diameter had
balanced sensitivity (80.5%), specificity (79%) and accuracy (79.7%) for
LMCo diagnosis, while a value of 44 mm had higher accuracy (81.7%), higher
specificity (91.5%) but lower sensitivity (71.9%). Pooled mortality after
non-conservative treatment (n = 150, predominantly stenting) was 2.7% at
up to 22 months of mean follow-up, with 83% survivors having no angina at
follow-up. <br/>Conclusion(s): PA diameter, PA/aorta ratio and CHD are
associated with LMCo, while hemodynamic parameters are not. Data from this
study support that a PA diameter cut-off between 40 and 44 mm can offer
optimal accuracy for LMCo screening. Preferred treatment was coronary
stenting, associated with low mid-term mortality and symptom relief.
Graphical abstract: Diagnosis and management of left main coronary artery
compression (LMCo) in patients with pulmonary arterial hypertension (PAH).
[Figure not available: see fulltext.]<br/>Copyright &#xa9; 2022, The
Author(s), under exclusive licence to Springer-Verlag GmbH Germany.

<10>
Accession Number
2015026360
Title
Target and non-target vessel related events at 10 years post percutaneous
coronary intervention.
Source
Clinical Research in Cardiology. 111(7) (pp 787-794), 2022. Date of
Publication: July 2022.
Author
Coughlan J.J.; Aytekin A.; Xhepa E.; Cassese S.; Joner M.; Koch T.; Wiebe
J.; Lenz T.; Rheude T.; Pellegrini C.; Gewalt S.; Ibrahim T.; Laugwitz
K.-L.; Schunkert H.; Kastrati A.; Kufner S.
Institution
(Coughlan, Aytekin, Xhepa, Cassese, Joner, Koch, Wiebe, Lenz, Rheude,
Pellegrini, Gewalt, Schunkert, Kastrati, Kufner) Deutsches Herzzentrum
Munchen, Technische Universitat Munchen, Lazarettstrasse, 36, Munich,
Germany
(Ibrahim, Laugwitz, Schunkert, Kastrati) Klinik Und Poliklinik Innere
Medizin I (Kardiologie, Angiologie Und Pneumologie), Klinikum rechts der
Isar, Technische Universitat Munchen, Munich, Germany
(Joner, Laugwitz, Schunkert, Kastrati) DZHK (German Center for
Cardiovascular Research), Partner Site Munich Heart Alliance, Munich,
Germany
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Aims: To define the incidence of events related to the stented vessel
(target vessel related events: TVRE) and events related to non-stented
vessels (non-target vessel related events: NTVRE) through to 10-year
follow-up in patients post-PCI with newer generation drug eluting stents
(DES). <br/>Methods and Results: The current study is a post-hoc analysis
of patient level data from two randomised controlled trials in Germany.
Patients older than 18 years with ischemic symptoms or evidence of
myocardial ischemia in the presence of >= 50% de novo stenosis located in
the native coronary vessels were considered eligible. The endpoints of
interest were TVRE (a composite of first target vessel myocardial
infarction or target vessel revascularization) and NTVRE (a composite of
first non-target vessel MI or non-target vessel revascularization) through
to 10 years post PCI. We included 4953 patients in this analysis. Through
to 10-years post-PCI, TVRE occurred in 1238 of 4953 patients (cumulative
incidence: 25.8%) and NTVRE occurred in 1442 of 4953 patients (cumulative
incidence: 30.3%). The majority of TVRE and NTVRE were revascularization
events. From 0 to 1 years, the cumulative incidence of TVRE was 15.9% and
of NTVRE was 12.3%. From 1 to 10 years, the cumulative incidences of TVRE
and NTVRE were 11.2% and 22.4%, respectively. <br/>Conclusion(s): At
10-year post-PCI with new generation drug eluting stents, events related
to remote vessel disease progression account for a higher proportion of
events than events related to the stented vessel. Trial registration: ISAR
TEST 4 ClinicalTrials.gov Identifier: NCT00598676. ISAR TEST 5
ClinicalTrials.gov Identifier: NCT00598533. Graphical abstract: [Figure
not available: see fulltext.]<br/>Copyright &#xa9; 2022, The Author(s).

<11>
Accession Number
2018390689
Title
A double-blind randomised feasibility trial of angiotensin-2 in cardiac
surgery^*.
Source
Anaesthesia. 77(9) (pp 999-1009), 2022. Date of Publication: September
2022.
Author
Coulson T.G.; Miles L.F.; Serpa Neto A.; Pilcher D.; Weinberg L.; Landoni
G.; Zarbock A.; Bellomo R.
Institution
(Coulson) Department of Anaesthesiology and Peri-Operative Medicine,
Monash University and Alfred Health, Melbourne, Australia
(Miles, Weinberg) Department of Anaesthesia, Austin Health, Melbourne,
Australia
(Serpa Neto) Australian and New Zealand Intensive Care Research Centre
(ANZIC-RC), Monash University, Melbourne, Australia
(Pilcher) Department of Intensive Care, Alfred Health, Melbourne,
Australia
(Landoni) Department of Anesthesia and Intensive Care, IRCCS San Raffaele
Scientific Institute and Vita-Salute San Raffaele University, Milan, Italy
(Zarbock) Department of Anaesthesiology, Intensive Care and Pain Medicine,
University Hospital Munster, Germany
(Bellomo) Department of Intensive Care, Austin Health, Melbourne,
Australia
Publisher
John Wiley and Sons Inc
Abstract
Acute kidney injury is common after cardiac surgery. Vasoplegic
hypotension may contribute to kidney injury, and different vasopressors
may have variable effects on kidney function. We conducted a double-blind,
randomised feasibility trial comparing peri-operative angiotensin-2 with
noradrenaline. We randomly allocated 60 patients at two centres to a
blinded equipotent angiotensin-2 or noradrenaline infusion
intra-operatively and for up to 48 h postoperatively, titrated to mean
arterial pressure of 70-80 mmHg. Primary feasibility outcomes included
consent rate, protocol adherence, infusion duration, mean arterial
pressure maintenance in the target range and major adverse outcomes.
Secondary outcomes included kidney injury rate. The consent rate was 47%.
Protocol adherence was 100% in the angiotensin-2 group and 94% in the
noradrenaline group. Study drug duration was median (IQR [range]) 217
(160-270 [30-315]) vs. 185 (135-301 [0-480]) min (p = 0.78) min
intra-operatively, and 5 (0-16 [0-48]) vs. 14.5 (4.8-29 [0-48]) hours (p =
0.075) postoperatively for angiotensin-2 and noradrenaline, respectively.
The mean arterial pressure target was achieved postoperatively in 25 of 28
(89%) of the angiotensin-2 group and 27 of 32 (84%) of the noradrenaline
group. One participant had a stroke, one required extracorporeal support
and three required renal replacement therapy, all in the noradrenaline
group (p = 0.99, p = 0.99 and p = 0.1). Acute kidney injury occurred in 7
of 28 in the angiotensin-2 group vs. 12 of 32 patients in the
noradrenaline group (p = 0.31). This pilot study suggests that a trial
comparing angiotensin-2 with noradrenaline is feasible. Its findings
justify further investigations of angiotensin-2 in cardiac
surgery.<br/>Copyright &#xa9; 2022 The Authors. Anaesthesia published by
John Wiley & Sons Ltd on behalf of Association of Anaesthetists.

<12>
Accession Number
2018372327
Title
Effectiveness of early cardiac rehabilitation in patients with heart valve
surgery: a randomized, controlled trial.
Source
Journal of International Medical Research. 50(7) (no pagination), 2022.
Date of Publication: July 2022.
Author
Xue W.; Xinlan Z.; Xiaoyan Z.
Institution
(Xue, Xinlan, Xiaoyan) Department of Cardiovascular Surgery, The First
Affiliated Hospital of Anhui Medical University, Anhui, Hefei, China
Publisher
SAGE Publications Ltd
Abstract
Objective: Complications of heart valve surgery lead to physical
inactivity and produce harmful effects. This study aimed to investigate
the role of a cardiac rehabilitation program and its long-term effect in
patients after heart valve surgery. <br/>Method(s): We performed a
single-blind, randomized, controlled trial. Patients with heart valve
surgery were randomly assigned to receive early cardiac rehabilitation
(intervention group, 44 patients) or the usual care (control group, 43
patients). The intervention group performed sitting, standing, and walking
exercises, followed by endurance training. The control group received
usual care and did not engage in any physical activity. Physical function
was assessed by the Short Physical Performance Battery (SPPB) and other
measurement tools. <br/>Result(s): The intervention group showed a
significant beneficial effect regarding physical capacity as shown by the
SPPB and the 6-minute walking test at hospital discharge, and a better
long-term effect was achieved at 6 months compared with the control group.
An improvement in physical function (e.g., the SPPB) after hospital
discharge predicted follow-up mortality (odds ratio = 0.416, 95%
confidence interval: 0.218-0.792). <br/>Conclusion(s): Early cardiac
rehabilitation appears to be an effective approach to improve the physical
function and survival of patients with heart valve surgery.<br/>Copyright
&#xa9; The Author(s) 2022.

<13>
Accession Number
2018028699
Title
Surgery for Anomalous Aortic Origin of a Coronary Artery (AAOCA) in
Children and Adolescents: A Meta-Analysis.
Source
World Journal for Pediatric and Congenital Heart Surgery. 13(4) (pp
485-494), 2022. Date of Publication: July 2022.
Author
Ponzoni M.; Frigo A.C.; Padalino M.A.
Institution
(Ponzoni, Padalino) Pediatric and Congenital Cardiac Surgery Unit, Veneto,
Padova, Italy
(Frigo) Unit of Biostatistics, Department of Cardiac, Vascular Sciences,
and Public Health, University of Padova Medical School, Thoracic, Italy
Publisher
SAGE Publications Inc.
Abstract
We conducted a systematic review and meta-analysis of the literature to
assess the outcomes of surgery for the anomalous aortic origin of a
coronary artery in children and young adults (<30 years). Thirteen
publications were selected, including a total of 384 patients. Unroofing
of the intramural segment was adopted in 92% (95% CI: 81%-98%) of cases,
with pooled early and late mortality of 0% (95% CI: 0%-0.3%) and 0.1% (95%
CI: 0%-1%), respectively. Reoperation for aortic regurgitation was
anecdotal. Surgical management of anomalous aortic origin of coronary
arteries can be achieved with excellent results in pediatric patients, but
concerns remain about the durability of surgery.<br/>Copyright &#xa9; The
Author(s) 2022.

<14>
Accession Number
2017828372
Title
Intraoperative hyperoxygenation may negatively affect postoperative
cognitive functions in coronary artery bypass graft operations: A
randomized controlled study.
Source
Journal of Cardiac Surgery. 37(9) (pp 2552-2563), 2022. Date of
Publication: September 2022.
Author
Onur T.; Karaca U.; Ata F.; Sayan H.E.; Onur A.; Yilmaz C.; Balkaya A.N.;
Eris C.
Institution
(Onur, Karaca, Ata, Sayan, Onur, Yilmaz, Balkaya) Departmant of
Anesthesiology and Reanimation, University of Health Sciences Bursa Yuksek
Ihtisas Training and Research Hospital, Bursa, Turkey
(Eris) Departmant of Cardiovascular Surgery, University of Health Sciences
Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
Publisher
John Wiley and Sons Inc
Abstract
Objective: In this study, it was aimed to compare various parameters
during surgery and postoperative cognitive functions in patients
undergoing coronary artery bypass graft (CABG) surgery using different
levels of perioperative oxygen. <br/>Method(s): One hundred patients
scheduled for elective CABG surgery were included in the study. The
patients were divided into two groups according to arterial oxygen levels
during surgery. In the normoxia group (NG) (n = 50), partial arterial
oxygen pressure (PaO<inf>2</inf>) was between >=100 and <180 mmHg with at
least 40% fraction of inspired oxygen (FiO<inf>2</inf>) mechanical
ventilation (MV), and in the hyperoxia group (HG) (n = 50),
PaO<inf>2</inf> was >=180 mmHg with 100% FiO<inf>2</inf> MV. Hemodynamic
parameters, peripheral oxygen saturation (SpO<inf>2</inf>), regional
cerebral oxygen saturation (rSO<inf>2</inf>) measured from bilateral
sensors, and blood gas values were recorded at the planned measurement
times. Postoperative features (mortality and infection rates, length of
stay in the hospital, and intensive care unit) and complications of the
patients have been recorded (low cardiac output syndrome, renal failure,
delirium). Mini-Mental State Examination (MMSE) test was applied to the
patients before and at the 12th, 24th hours; on the first, third, sixth
months after surgery. <br/>Result(s): Extubation time was found to be
shorter in NG (p <.05). Between the groups, rSO<inf>2</inf> and mean
arterial pressure were found to be significantly lower in HG at the time
of T4 measurement (p =.042, p =.038, respectively). MMSE values of the
groups at the first, third, and sixth months were found to be
significantly higher in NG (p =.017, p =.014, p =.002, respectively).
<br/>Conclusion(s): Hyperoxemia application during CABG may be associated
with worse postoperative late-term cognitive functions.<br/>Copyright
&#xa9; 2022 Wiley Periodicals LLC.

<15>
[Use Link to view the full text]
Accession Number
2015979733
Title
Effect of Electroencephalography Spectral Edge Frequency (SEF) and Patient
State Index (PSI)-Guided Propofol-Remifentanil Anesthesia on Delirium
After Laparoscopic Surgery: The eMODIPOD Randomized Controlled Trial.
Source
Journal of Neurosurgical Anesthesiology. 34(2) (pp 183-192), 2022. Date of
Publication: 01 Apr 2022.
Author
Wang E.; Wang L.; Ye C.; Luo N.; Zhang Y.; Zhong Y.; Zhu M.; Zou Y.; Li
Q.; Li L.; Song Z.; Luo H.; Dai F.; Liu H.; Gelb A.W.; Guo Q.; Meng L.
Institution
(Wang, Wang, Ye, Luo, Zhang, Zhong, Zhu, Zou, Li, Li, Song, Luo, Guo)
Department of Anesthesiology, Xiangya Hospital, Central South University,
Changsha Hunan Province, China
(Dai) Departments of Biostatistics
(Meng) Anesthesiology, Yale University, School of Medicine, New Haven, CT,
United States
(Liu) Department of Anesthesiology and Pain Medicine, University of
California Davis, Sacramento, United States
(Gelb) Department of Anesthesia and Perioperative Care, University of
California San Francisco, San Francisco, CA, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Background: The effect of SedLine electroencephalography (EEG)-guided
anesthetic care on postoperative delirium (POD) has not been studied.
<br/>Method(s): This single-center randomized EEG Monitoring tO Decrease
the Incidence of Post-Operative Delirium (eMODIPOD) trial involved 1560
patients aged 50 years or above undergoing laparoscopic surgery.
Propofol-remifentanil anesthesia was guided either by SedLine (EEG-guided
care, n=779) or not (usual care, n=781). The goal of EEG-guided care was
to maintain spectral edge frequency between 10 and 15 and patient state
index (PSI) between 25 and 50. The primary outcome was the incidence of
POD on postoperative days 1 to 5. The secondary outcomes included
emergence delirium, composite moderate-to-severe complications, length of
hospital stay, intensive care unit admission, 30-day hospital readmission
and all-cause mortality, and intraoperative awareness. <br/>Result(s): Of
the 1560 randomized patients, 1545 were included in the modified
intention-to-treat analysis. The median propofol administered for
anesthesia maintenance was 900 mg and 1000 mg in the EEG-guided and usual
care groups, respectively (P=0.21). POD occurred in 1.0% (8/771) and 1.2%
(9/774) of patients in the EEG-guided and usual care groups, respectively
(risk ratio: 0.89; 95% confidence interval: 0.35-2.30). There were no
between-group differences in all secondary outcome measures. Emergence
delirium occurred in 11.8% (91/771) and 13.2% (102/774) of the EEG-guided
care and usual care groups, respectively (risk ratio: 0.90; 95% confidence
interval: 0.69-1.17; P=0.41). Three patients from each group reported
intraoperative awareness. <br/>Conclusion(s): Compared with usual care,
SedLine spectral edge frequency-guided and patient state index-guided
propofol-remifentanil anesthetic care neither alters anesthetic delivery
nor decreases the unexpected low incidence of POD in relatively young
Chinese patients undergoing laparoscopic surgery.<br/>Copyright &#xa9;
2022 Lippincott Williams and Wilkins. All rights reserved.

<16>
Accession Number
2014308080
Title
Ultrafiltration and cardiopulmonary bypass associated acute kidney injury:
A systematic review and meta-analysis.
Source
Clinical Cardiology. 44(12) (pp 1700-1708), 2021. Date of Publication:
December 2021.
Author
Kandil O.A.; Motawea K.R.; Darling E.; Riley J.B.; Shah J.; Elashhat
M.A.M.; Searles B.; Aiash H.
Institution
(Kandil, Motawea) Faculty of Medicine, Alexandria University, Alexandria,
Egypt
(Darling, Riley, Searles, Aiash) Department of Cardiovascular Perfusion,
State University of New York Upstate Medical University, Syracuse, NY,
United States
(Shah) Medical Research Center, Kateb University, Kabul, Afghanistan
(Elashhat) Aswan Heart Center (Magdy Yacoub Foundation), Aswan
Governorate, Aswan, Egypt
(Aiash) Department of Family Medicine, Faculty of Medicine, Suez Canal
University, Ismailia, Egypt
(Aiash) Department of Surgery, State University of New York Upstate
Medical University, Syracuse, NY, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Cardiopulmonary bypass is known to raise the risk of acute
kidney injury (AKI). Previous studies have identified numerous risk
factors of cardiopulmonary bypass including the possible impact of
perioperative ultrafiltration. However, the association between
ultrafiltration (UF) and AKI remains conflicting. Thus, we conducted a
meta-analysis to further examine the relationship between UF and AKI.
Hypothesis: Ultrafiltration during cardiac surgery increases the risk of
developping Acute kidney Injury. <br/>Method(s): We searched PubMed, Web
of Science, EBSCO, and SCOPUS through July 2021. The RevMan (version 5.4)
software was used to calculate the pooled risk ratios (RRs) and mean
differences along with their associated confidence intervals (95% CI).
<br/>Result(s): We identified 12 studies with a total of 8005 patients.
There was no statistically significant difference in the incidence of AKI
between the group who underwent UF and the control group who did not (RR =
0.90, 95% CI = 0.64-1). Subgroup analysis on patients with previous renal
insufficiency also yielded nonsignificant difference (RR = 0.84, 95% CI =
0.53 -1.33, p =.47). Subgroup analysis based on volume of ultrafiltrate
removed (> or <2900 ml) was not significant and did not increase the AKI
risk as predicted (RR = 0.82, 95% CI = 0.63 -1.07, p =.15). We also did
subgroup analysis according to the type of UF and again no significant
difference in AKI incidence between UF groups and controls was observed in
either the conventional ultrafiltration (CUF), modified ultrafiltration
(MUF), zero-balanced ultrafiltration (ZBUF), or combined MUF and CUF
subgroups. <br/>Conclusion(s): UF in cardiac surgery is not associated
with increased AKI incidence and may be safely used even in baseline
chronic injury patients.<br/>Copyright &#xa9; 2021 The Authors. Clinical
Cardiology published by Wiley Periodicals LLC.

<17>
Accession Number
637834405
Title
Mechanical versus bioprosthetic valve for aortic valve replacement:
systematic review and meta-analysis of reconstructed individual
participant data.
Source
European journal of cardio-thoracic surgery : official journal of the
European Association for Cardio-thoracic Surgery. 62(1) (no pagination),
2022. Date of Publication: 15 Jun 2022.
Author
Tasoudis P.T.; Varvoglis D.N.; Vitkos E.; Mylonas K.S.; Sa M.P.;
Ikonomidis J.S.; Caranasos T.G.; Athanasiou T.
Institution
(Tasoudis, Varvoglis, Vitkos) Department of Cardiothoracic Surgery,
Faculty of Medicine, School of Health Sciences, University of Thessaly,
Biopolis, Greece
(Tasoudis, Varvoglis, Vitkos) Surgery Working Group, Society of Junior
Doctors, Athens, Greece
(Mylonas) Department of Cardiac Surgery, Onassis Cardiac Surgery Center,
Athens, Greece
(Sa) Department of Cardiothoracic Surgery Research, Lankenau Institute for
Medical Research, Wynnewood, PA, United States
(Ikonomidis, Caranasos) Division of Cardiothoracic Surgery, Department of
Surgery, School of Medicine, University of North Carolina at Chapel Hill,
Chapel Hill, NC, United States
(Athanasiou) Department of Surgery and Cancer, Imperial College London, St
Mary's Hospital, London, United Kingdom
(Athanasiou) Department of Cardiothoracic Surgery, University Hospital of
Larissa, Biopolis, Greece
Publisher
NLM (Medline)
Abstract
OBJECTIVES: The aim of this study was to compare biological versus
mechanical aortic valve replacement. <br/>METHOD(S): We searched MEDLINE,
Scopus and Cochrane Library databases for randomized clinical trials and
propensity score-matched studies published by 14 October 2021 according to
the Preferred Reporting Items for Systematic Reviews and Meta-analyses
statement. Individual patient data on overall survival were extracted.
One- and two-stage survival analyses and random-effects meta-analyses were
conducted. <br/>RESULT(S): A total of 25 studies were identified,
incorporating 8721 bioprosthetic and 8962 mechanical valves. In the
one-stage meta-analysis, mechanical valves cumulatively demonstrated
decreased hazard for mortality [hazard ratio (HR): 0.79, 95% confidence
interval (CI): 0.74-0.84, P<0.0001]. Overall survival was similar between
the compared arms for patients <50years old (HR: 0.88, 95% CI: 0.71-1.1,
P=0.216), increased in the mechanical valve arm for patients 50-70years
old (HR: 0.76, 95% CI: 0.70-0.83, P<0.0001) and increased in the
bioprosthetic arm for patients >70years old (HR: 1.35, 95% CI: 1.17-1.57,
P<0.0001). Meta-regression analysis revealed that the survival in the
50-70year-old group was not influenced by the publication year of the
individual studies. No statistically significant difference was observed
regarding in-hospital mortality, postoperative strokes and postoperative
reoperation. All-cause mortality was found decreased in the mechanical
group, cardiac mortality was comparable between the 2 groups, major
bleeding rates were increased in the mechanical valve group and
reoperation rates were increased in the bioprosthetic valve group.
<br/>CONCLUSION(S): Survival rates seem to not be influenced by the type
of prosthesis in patients <50years old. The survival advantage in favour
of mechanical valves is observed in patients 50-70years old, while in
patients >70years old bioprosthetic valves offer better survival
outcomes.<br/>Copyright &#xa9; The Author(s) 2022. Published by Oxford
University Press on behalf of the European Association for Cardio-Thoracic
Surgery. All rights reserved.

<18>
Accession Number
637041955
Title
Determining the Effectiveness of Forced-Air Warming Blankets in
Maintaining Postoperative Body Temperature: A Randomized Controlled Trial.
Source
Journal of perianesthesia nursing : official journal of the American
Society of PeriAnesthesia Nurses. 37(4) (pp 533-539), 2022. Date of
Publication: 01 Aug 2022.
Author
Isikli A.G.; Findik UY.
Institution
(Isikli) Trakya University, Health Research and Practice Centre of Trakya
University, Thoracic Surgery Department, Balkan Campus, Edirne, Turkey
(Findik) Trakya University Faculty of Health Sciences Nursing Department,
Trakya University Balkan Campus, Edirne, Turkey
Publisher
NLM (Medline)
Abstract
PURPOSE: The aim of this study is to determine the effectiveness of
forced-air warming blankets in normalizing body temperature in the
postoperative period. DESIGN: Randomized controlled trial METHODS: The
study sample consisted of patients (N = 67) who underwent lung lobectomy
in the Thoracic Surgery Service of a university hospital. Forced-air
warming blankets were used in the treatment group and 100% cotton blankets
were used in the control group. Patients' body temperatures were monitored
using a tympanic thermometer until it reached 37degreeC. FINDINGS: The
body temperature of the patients in the treatment group reached 37degreeC
in a shorter time than that of the patients in the control group (52.27
+/- 29.79 min and 139.0 +/- 81.93 min, respectively; P < .001), and that
the perception of comfort of the patients in the treatment and control
groups increased (P < .001) after warming. <br/>CONCLUSION(S): We
recommend that forced-air warming blankets are used for patients
undergoing lung lobectomy in order to reach normal body temperature in a
shorter time.<br/>Copyright &#xa9; 2021 American Society of PeriAnesthesia
Nurses. Published by Elsevier Inc. All rights reserved.

<19>
Accession Number
2018371718
Title
Cognitive function before and after intravenous iron supplement for iron
deficiency in heart transplant recipients.
Source
Journal of Psychosomatic Research. Conference: Ninth Annual Scientific
Conference of the European Association of Psychosomatic Medicine (EAPM).
Vienna Austria. 157 (no pagination), 2022. Article Number: 110831. Date of
Publication: June 2022.
Author
Burker B.; Brautaset Englund K.; Gullestad L.; Broch K.
Institution
(Burker, Brautaset Englund, Gullestad, Broch) Oslo University Hospital,
Oslo, Norway
(Brautaset Englund, Gullestad, Broch) University of Oslo, Oslo, Norway
Publisher
Elsevier Inc.
Abstract
Objective: Cognitive dysfunction has been demonstrated after heart
transplantation (HTx). In a previous study, lower haemoglobin was
associated with Mild Cognitive Impairment among HTx recipients. We
examined in a randomized, placebo-controlled, double-blind trial
(https://doi.org/10.1016/j.healun.2021.01.1390), as pre-specified
secondary outcome, whether intravenous iron supplement for iron deficiency
resulted in changes in cognitive function 6 months after intervention.
<br/>Method(s): Cognitive function was assessed by tests from the
Cambridge Neuropsychological Test Automated Battery (CANTAB) and included
assessment of psychomotor speed (Reaction Time), visual memory (Paired
Associates Learning), and working memory/executive function (Spatial
Working Memory). Change from baseline to follow-up in the raw scores of 2
individual measures for each cognitive domain was analysed.
<br/>Result(s): Of 94 participants (36.2% female) with cognitive data at
baseline and follow-up, 57.4% were transplanted due to dilated
cardiomyopathy. At time of inclusion, mean age was 54.5 +/- 14.1 years and
participants had been transplanted on average 8.5 +/- 6.4 years earlier.
Mean z-scores at baseline ranged from -0.5 to -0.6 on both measures of
visual memory as well as of working memory/executive function. Change in
performance did not differ statistically significant between treatment
arms for any of the 6 individual measures. <br/>Conclusion(s): HTx
recipients with iron deficiency performed, on the group level,
approximately half a standard deviation below normative mean on measures
of visual memory and working memory/executive function. Compared to
placebo, intravenous iron supplement did not result in statistically
significant different changes in performance on measures of psychomotor
speed, visual memory, and working memory/executive function after 6
months.<br/>Copyright &#xa9; 2022

<20>
Accession Number
2018442007
Title
Perioperative Hemodynamic Optimization in Patients at Risk for Delirium -
A Randomized-Controlled Trial.
Source
Frontiers in Medicine. 9 (no pagination), 2022. Article Number: 893459.
Date of Publication: 13 Jul 2022.
Author
Fuest K.E.; Servatius A.; Ulm B.; Schaller S.J.; Jungwirth B.; Blobner M.;
Schmid S.
Institution
(Fuest, Servatius, Ulm, Schaller, Jungwirth, Blobner, Schmid) Department
of Anesthesiology and Intensive Care, Technical University of Munich,
School of Medicine, Klinikum rechts der Isar, Munich, Germany
(Schaller) Department of Anesthesiology and Operative Intensive Care
Medicine, Charite - Universitatsmedizin Berlin, Freie Universitat Berlin,
Humboldt-Universitat zu Berlin and Berlin Institute of Health, Berlin,
Germany
(Jungwirth, Blobner, Schmid) Department of Anesthesiology and Intensive
Care Medicine, University Hospital Ulm, Ulm University, Ulm, Germany
Publisher
Frontiers Media S.A.
Abstract
Background: Post-operative delirium is common in elderly patients and
associated with increased morbidity and mortality. We evaluated in this
pilot study whether a perioperative goal-directed hemodynamic optimization
algorithm improves cerebral oxygenation and can reduce the incidence of
delirium. <br/>Material(s) and Method(s): Patients older than 70 years
with high risk for post-operative delirium undergoing elective non-cardiac
surgery were randomized to an intervention or control group. Patients in
the intervention group received a perioperative hemodynamic optimization
protocol based on uncalibrated pulse-contour analysis. Patients in the
control group were managed according to usual standard of care. Incidence
of delirium until day seven was assessed with confusion assessment method
(CAM) and chart review. Cerebral oxygenation was measured with
near-infrared spectroscopy. <br/>Result(s): Delirium was present in 13 of
85 (15%) patients in the intervention group and 18 of 87 (21%) in the
control group [risk difference -5.4%; 95% confidence interval, -16.8 to
6.1%; P = 0.47]. Intervention did not influence length of stay in hospital
or in-hospital mortality. Amounts of fluids and vasopressors applied, mean
arterial pressure, cardiac index, and near-infrared spectroscopy values
were comparable between groups. <br/>Conclusion(s): The hemodynamic
algorithm applied in high-risk non-cardiac surgery patients did not change
hemodynamic interventions, did not improve patient hemodynamics, and
failed to increase cerebral oxygenation. An effect on the incidence of
post-operative delirium could not be observed. Clinical Trial
Registration: [Clinicaltrials.gov], identifier
[NCT01827501].<br/>Copyright &#xa9; 2022 Fuest, Servatius, Ulm, Schaller,
Jungwirth, Blobner and Schmid.

<21>
Accession Number
2018441948
Title
Patency and adverse outcomes of sequential vs. individual saphenous vein
grafts in coronary artery bypass: A meta-analysis.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 944717. Date of Publication: 22 Jul 2022.
Author
Jiao H.; Li J.; Bai Y.; Guo Z.
Institution
(Jiao) Academy of Medical Engineering and Translational Medicine, Tianjin
University, Tianjin, China
(Jiao, Bai, Guo) Department of Cardiac Surgery, Chest Hospital, Tianjin
University, Tianjin, China
(Li, Bai, Guo) Clinical School of Thoracic, Tianjin Medical University,
Tianjin, China
Publisher
Frontiers Media S.A.
Abstract
Objectives: To undertake a systematic review and meta-analysis of cohort
studies to compare the patency and adverse outcomes of sequential and
individual saphenous vein grafts (SVGs) in coronary artery bypass grafting
(CABG). <br/>Method(s): We searched PubMed, Embase, and the Cochrane
Library for cohort studies. Endpoints for vein graft failure,
perioperative and follow-up adverse events were extracted as risk ratio
(RR) with 95% confidence intervals (95% CI). Statistical heterogeneity
across the studies was examined using the I² statistic.
Potential of publication bias was evaluated quantitatively by the Egger's
test. Sensitivity analysis was also performed to assess the robustness of
our outcomes. <br/>Result(s): The 15 studies were analyzed, including
22,004 patients, 4,580 grafts, and seven different adverse events under
individual or sequential CABG. The sequential group had inferior graft
failure (RR = 0.68; 95% CI, 0.60-0.77) and long-term mortality (RR = 0.76;
95%CI, 0.61-0.95), but with an increased risk of perioperative repeat
revascularization (RR = 1.58; 95%CI, 1.16-2.14) than the individual group.
<br/>Conclusion(s): Taken together, our analysis of the aggregated
evidence comparing the sequential and individual saphenous vein grafts for
coronary heart disease patients showed that the use of the sequential
graft was associated with inferior graft failure and long-term mortality
respectively, but with an increased risk of perioperative repeat
revascularization. According to our study, both surgical techniques have
their own advantages in efficacy and safety, and the selection of surgical
techniques should be based on patients and surgeons. Sequential saphenous
vein grafts should be more recommended to experienced surgeons in order to
both reduce perioperative adverse events and improve long-term patency.
Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/,
identifier CRD42022326992.<br/>Copyright &#xa9; 2022 Jiao, Li, Bai and
Guo.

<22>
Accession Number
638673341
Title
Comment on "The effect of preoperative chest physiotherapy on oxygenation
and lung function in cardiac surgery patients: a randomized controlled
study".
Source
Annals of Saudi medicine. 42(4) (pp 288-289), 2022. Date of Publication:
01 Jul 2022.
Author
Kashoo F.Z.; Ahmad M.; Sidiq M.; Shahood H.
Institution
(Kashoo) From the Department of Physical Therapy and Health
Rehabilitation, Majmaah University College of Applied Medical Sciences,
King Khalid Hospital Majmaah, Riyadh, Saudi Arabia
(Ahmad) From the Department of Nursing, Majmaah University College of
Applied Medical Sciences, King Khalid Hospital Majmaah, Riyadh, Saudi
Arabia
(Sidiq) From the Faculty of Physiotherapy, Madhav University, Rajasthan,
India
(Shahood) From the Doctoral School of Health Sciences, University of Pecs
Medical School, Pecs, Hungary
Publisher
NLM (Medline)

<23>
Accession Number
638673056
Title
Preoperative hypoalbuminemia in patients undergoing cardiac surgery: a
meta-analysis.
Source
Surgery today. (no pagination), 2022. Date of Publication: 07 Aug 2022.
Author
Xu R.; Hao M.; Zhou W.; Liu M.; Wei Y.; Xu J.; Zhang W.
Institution
(Xu, Hao, Zhou, Liu, Wei, Xu) Department of Cardio-Thoracic Surgery,
Second Affiliated Hospital of Nanchang University, 1 Minde Road, Nanchang
330006, China
(Xu, Hao, Zhou, Liu) Jiangxi Medical College, Nanchang University,
Nanchang 330006, China
(Zhang) Department of Cardio-Thoracic Surgery, Second Affiliated Hospital
of Nanchang University, 1 Minde Road, Nanchang 330006, China
Publisher
NLM (Medline)
Abstract
The preoperative serum albumin level has been shown to be associated with
adverse postoperative complications, meaning that hypoalbuminemia may also
be a risk factor. We performed a meta-analysis to evaluate the association
of serum albumin levels with survival and complication rates after cardiac
surgery. Relevant articles were identified through seven databases. Twenty
studies with 22553 patients (hypoalbuminemia group, n=9903; normal group,
n=12650) who underwent cardiac surgery met the inclusion criteria after
screening. The primary outcomes were that hypoalbuminemia was
significantly correlated with serious long-term all-cause mortality
(hazard ratio [HR]: 1.95 [1.54-2.48]; P<0.00001) and increased mortality
(risk ratio [RR]=1.91 [1.61-2.27], P<0.00001). Hypoalbuminemic patients
with cardiopathy were more likely to suffer postoperative complications
(bleeding, infections, renal injury, and others) than those whose serum
albumin levels were normal. Furthermore, hypoalbuminemia increased the
time in the intensive-care unit (ICU) (mean difference [MD]=1.18
[0.49-1.87], P=0.0008), length of hospital stay (LOS) (MD=3.34, 95% CI:
1.88-4.80, P<0.00001), and cardiopulmonary bypass time (CPB) (MD=12.40
[1.13-23.66], P=0.03). Hypoalbuminemia in patients undergoing cardiac
surgery appears to have a poor all-cause mortality or increased risk of
complications. Adjusted perioperative serum albumin levels and treatment
strategies for this high-risk population have the potential to improve the
survival.<br/>Copyright &#xa9; 2022. The Author(s) under exclusive licence
to Springer Nature Singapore Pte Ltd.

<24>
Accession Number
638666084
Title
Preliminary Report from a Randomized Controlled Trial Comparing Two Bovine
Pericardial Valves.
Source
The Thoracic and cardiovascular surgeon. (no pagination), 2022. Date of
Publication: 02 Aug 2022.
Author
Sohn S.H.; Choi J.W.; Lee J.H.; Kim J.S.; Lim C.; Hwang H.Y.
Institution
(Sohn, Kim, Choi, Hwang) Department of Thoracic and Cardiovascular
Surgery, Seoul National University Hospital, Seoul, South Korea
(Lee, Kim, Lim) Department of Thoracic and Cardiovascular Surgery, Seoul
National University Bundang Hospital, Seongnam, South Korea
Publisher
NLM (Medline)
Abstract
BACKGROUND: A randomized controlled trial was designed to compare 1-year
hemodynamic profiles and clinical outcomes after bioprosthetic aortic
valve replacement (AVR) using a recently introduced (study group) and
world-widely used (control group) bovine pericardial bioprostheses. This
study evaluated early postoperative outcomes as a preliminary analysis.
<br/>METHOD(S): The primary end point of the trial was the mean pressure
gradient across the aortic valve (AVMPG) at 1 year after surgery. Patients
were screened to enroll 70 patients in each group based on a
noninferiority design. Early postoperative hemodynamic and clinical
outcomes were compared between the two groups. <br/>RESULT(S): There were
no differences in baseline characteristics, including sex and body surface
area (1.64+/-0.18 vs. 1.65+/-0.15 m2) between the two groups. The AVMPG on
early postoperative echocardiography was 15.2+/-4.6mm Hg and 16.5+/-6.2mm
Hg in the study and control groups, respectively (p=0.177). Although AVMPG
of the 19mm prostheses was lower in the study group than in the control
group (17.0+/-6.3mm Hg vs. 22.8+/-6.6mm Hg, p=0.039), there were no
significant differences in the effective orifice area in all patients
(1.57+/-0.41cm2 vs. 1.53+/-0.34cm2, p=0.568), and each valve size. The
effective orifice area index was also similar between the two groups in
overall (p=0.352), and in each valve size. There were no significant
differences in clinical outcomes including operative mortality and
postoperative complications between the two groups. <br/>CONCLUSION(S):
Early postoperative hemodynamic and clinical results after AVR using a
recently introduced bovine pericardial valve were comparable with those
using the control valve (NCT03796442).<br/>Copyright Thieme. All rights
reserved.

<25>
Accession Number
638665080
Title
Intraoperative Respiratory and Hemodynamic Strategies for Reducing Nausea,
Vomiting, and Pain after Surgery: Systematic Review and Meta-Analysis.
Source
Acta anaesthesiologica Scandinavica. (no pagination), 2022. Date of
Publication: 04 Aug 2022.
Author
Holst J.M.; Klitholm M.P.; Henriksen J.; Vallentin M.F.; Jessen M.K.;
Bolther M.; Holmberg M.J.; Hoybye M.; Lind P.C.; Granfeldt A.; Andersen
L.W.
Institution
(Holst, Klitholm, Henriksen, Bolther, Lind, Granfeldt, Andersen)
Department of Anesthesiology and Intensive Care, Aarhus University
Hospital, Aarhus, Denmark
(Vallentin, Jessen, Holmberg, Hoybye, Lind, Granfeldt, Andersen)
Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
(Vallentin, Andersen) Prehospital Emergency Medical Services, Central
Denmark Region ,Aarhus, Denmark
(Jessen, Holmberg, Hoybye, Andersen) Research Center for Emergency
Medicine, Aarhus University Hospital, Aarhus, Denmark
(Holmberg) Department of Anesthesiology and Intensive Care, Randers
Regional Hospital, Randers, Denmark
Publisher
NLM (Medline)
Abstract
BACKGROUND: Despite improved medical treatment strategies, post-operative
pain, nausea, and vomiting remain major challenges. This systematic review
investigated the relationship between perioperative respiratory and
hemodynamic interventions and postoperative pain, nausea, and vomiting.
<br/>METHOD(S): PubMed and Embase were searched on March 8, 2021 for
randomized clinical trials investigating the effect of perioperative
respiratory or hemodynamic interventions in adults undergoing non-cardiac
surgery. Investigators reviewed trials for relevance, extracted data, and
assessed risk of bias. Meta-analyses were performed when feasible. GRADE
was used to assess the certainty in the evidence. <br/>RESULT(S): This
review included 65 original trials; of these 48% had pain, nausea and/or
vomiting as the primary focus. No reduction of postoperative pain was
found in meta-analyses when comparing recruitment maneuvers with no
recruitment, high (80%) to low (30%) fraction of oxygen, low (5-7 ml/kg)
to high (9-12 ml/kg) tidal volume, or goal-directed hemodynamic therapy to
standard care. In the meta-analysis comparing recruitment maneuvers with
no recruitment maneuvers, patients undergoing laparoscopic gynecological
surgery had less shoulder pain 24 hours postoperatively (mean difference
in the numeric rating scale from 0 to 10: -1.1, 95% CI: -1.7, -0.5). In
meta-analyses, comparing high to low fraction of inspired oxygen and
goal-directed hemodynamic therapy to standard care in patients undergoing
abdominal surgery, the risk of postoperative nausea and vomiting was
reduced (odds ratio: 0.45, 95% CI: 0.24, 0.87 and 0.48, 95% CI: 0.27,
0.85). The certainty in the evidence was mostly very low to low. The
results should be considered exploratory given the lack of pre-specified
hypotheses and corresponding risk of Type 1 errors. <br/>CONCLUSION(S):
There is limited evidence regarding the impact of intraoperative
respiratory and hemodynamic interventions on postoperative pain or nausea
and vomiting. More definitive trials are needed to guide clinical care
within this area. This article is protected by copyright. All rights
reserved.

<26>
Accession Number
638664904
Title
The current practice of transcatheter aortic valve replacement in China.
Source
Journal of cardiac surgery. (no pagination), 2022. Date of Publication:
04 Aug 2022.
Author
Xie C.-M.; Yao Y.-T.
Institution
(Xie) Department of Anesthesiology, Fuwai Yunnan Cardiovascular Hospital,
Affiliated Cardiovascular Hospital of Kunming Medical University, Kunming,
China
(Yao) Department of Anesthesiology, Fuwai Hospital, National Center for
Cardiovascular Diseases, Peking Union Medical College and Chinese Academy
of Medical Sciences, Beijing, China
Publisher
NLM (Medline)
Abstract
OBJECTIVE: The purpose of this study is to summarize the current practice
and experience of transcatheter aortic valve replacement in China.
<br/>METHOD(S): The relevant articles were identified through computerized
searches of the CNKI, WANFANG, VIP, and PubMed databases through February
1, 2022, using the search terms: "transcatheter aortic valve replacement,"
"transcatheter aortic valve implantation," "China." RESULTS: The database
searches identified 22 articles, 2092 patients, 57.65% were male, with a
mean age of 74.2+/-6.0 years, 71.51% of patients were classified by New
York Heart Association as class III/IV, Society of Thoracic Surgeons score
8.4+/-4.1, mean left ventricular ejection fraction 52.8+/-14.2%, mean
transvalvular aortic pressure gradient 59.9+/-18.9mmHg. The overall
procedural success rate was 97.85%, and 2.15% of patients were converted
to sternotomy, mainly due to transcatheter aortic bioprosthesis
dislocation. The most common vascular access approach was transfemoral
(1071 patients, 51.20%). General anesthesia (48.90%) was the commonly used
anesthesia technique. The incidence of postprocedural complications was as
follows: permanent pacemaker implantation (10.47%), bleeding events
(8.60%), mild paravalvular leakage (17.73%), moderate and severe
paravalvular leakage (4.16%), vascular complications (3.30%), stroke
(1.43%), respectively. The overall periprocedural period and
postprocedural 30-day mortality was 2.72%. <br/>CONCLUSION(S): Among
patients undergoing transcatheter aortic valve replacement in China,
device implantation success was achieved in 97.85% of cases. The most
common vascular access approach was transfemoral. General anesthesia was
the most commonly used anesthetic technique. Paravalvular leakage (458
patients, 21.89%) was the most common complication.<br/>Copyright &#xa9;
2022 Wiley Periodicals LLC.

<27>
Accession Number
638661776
Title
Predicting Non-home Discharge after Lung Surgery: Analysis of the General
Thoracic Surgery Database.
Source
The Annals of thoracic surgery. (no pagination), 2022. Date of
Publication: 31 Jul 2022.
Author
Karush J.M.; Alex G.; Geissen N.; Wakefield C.; Basu S.; Liptay M.J.;
Seder C.W.
Institution
(Karush, Alex, Geissen, Basu, Liptay, Seder) Department of Cardiovascular
and Thoracic Surgery, Rush University Medical Center, Chicago, IL, United
States
(Wakefield) Rush Medical College, Chicago, IL, United States
Publisher
NLM (Medline)
Abstract
BACKGROUND: Anticipating the need for non-home discharge (NHD) enables
improved patient counseling and expedites placement, potentially reducing
length of stay and hospital readmission. The objective of this study was
to create a simple, preoperative, clinical prediction tool for NHD using
the Society of Thoracic Surgeons General Thoracic Surgery Database (STS
GTSD). <br/>METHOD(S): The STS GTSD was queried for patients who underwent
elective anatomic lung cancer resection between 2009-2019. Exclusion
criteria included age<18, DLCO< 20% or >150%, N3 or M1 disease, incomplete
datasets, and mortality. The primary outcome was defined as discharge to
an extended care, transitional care, rehabilitation center, or another
hospital. Multivariable logistic regression was used to select risk
factors and a nomogram for predicting risk of NHD was developed. The
approach was cross validated in 100 replications of a training set
consisting of randomly selected 2/3rd of the cohort and a validation set
of remaining patients. <br/>RESULT(S): A total of 35948 patients from the
STS GTSD met inclusion criteria. Final model variables used to derive the
nomogram for NHD risk prediction included age (P<0.001), DLCO% (P<0.001),
open surgery (P0.001), cerebrovascular history (P<0.001), and Zubrod score
(P<0.001). The ROC curve, using sensitivities and specificities of the
model, yielded AUC =0.74. In 100 replicated cross-validations,
out-of-sample AUC ranged 0.72-0.76. <br/>CONCLUSION(S): Using readily
available preoperative variables, our nomogram prognosticates the risk of
non-home discharge after anatomic lung resection with good discriminatory
ability. Such risk stratification can enable improved patient counseling
and facilitate better planning of patients' post-operative
needs.<br/>Copyright &#xa9; 2022 The Society of Thoracic Surgeons.
Published by Elsevier Inc. All rights reserved.

<28>
Accession Number
2019498378
Title
Transcatheter Tricuspid Valve Replacement for Tricuspid Regurgitation: A
Systematic Review and Meta-analysis.
Source
Anatolian Journal of Cardiology. 26(7) (pp 505-519), 2022. Date of
Publication: July 2022.
Author
Bugan B.; Cekirdekci E.I.; Onar L.C.; Barcin C.
Institution
(Bugan, Barcin) Department of Cardiology, Gulhane Training and Research
Hospital, Ankara, Turkey
(Cekirdekci) Department of Cardiology, University of Kyrenia, Kyrenia,
Cyprus
(Onar) Department of Cardiovascular Surgery, Dr. Ismail Fehmi Cumalioglu
Government Hospital, Tekirdag, Turkey
Publisher
Turkish Society of Cardiology
Abstract
Background: The present data aim to evaluate the feasibility of the
orthotopic transcatheter tricuspid valve replacement devices,
echocardiographic, functional improvements, and mortality rates following
replacement in patients with significant tricuspid valve regurgitation.
<br/>Method(s): We systematically searched for the studies evaluating the
efficacy and safety of transcatheter tricuspid valve replacement for
significant tricuspid valve regurgitation. The efficacy and safety
outcomes were the improvements in New York Heart Association functional
class, 6-minute walking distance, all-cause death, and periprocedural and
long-term complications. In addition, a random-effect meta-analysis was
performed comparing outcomes before and after transcatheter tricuspid
valve replacement. <br/>Result(s): Nine studies with 321 patients were
included. The mean age was 75.8 years, and the mean European System for
Cardiac Operative Risk Evaluation II score was 8.2% (95% CI: 6.1 to 10.3).
Severe, massive, and torrential tricuspid valve regurgitation was
diagnosed in 95% of patients (95% CI: 89% to 98%), and 83% (95% CI: 73% to
90%) of patients were in New York Heart Association functional class III
or IV. At a weighted mean follow-up of 122 days, New York Heart
Association functional class (risk ratio = 0.20; 95% CI: 0.11 to 0.35; P <
.001) and 6-minute walking distance (mean difference = 91.1 m; 95% CI:
37.3 to 144.9 m; P < .001) significantly improved, and similarly, the
prevalence of severe or greater tricuspid valve regurgitation was
significantly reduced after transcatheter tricuspid valve replacement
(baseline risk ratio = 0.19; 95% CI: 0.10 to 0.36; P < .001). In total, 28
patients (10%; 95% CI: 6% to 17%) had died. Pooled analyses demonstrated
non-significant differences in hospital and 30-day mortality and >30-day
mortality than predicted operative mortality (risk ratio = 1.03; 95% CI:
0.41 to 2.59; P= .95, risk ratio = 1.39; 95% CI: 0.69 to 2.81; P= .35,
respectively). <br/>Conclusion(s): Transcatheter tricuspid valve
replacement could be an emerging treatment option for patients with severe
tricuspid regurgitation who are not eligible for transcatheter repair or
surgical replacement because of high surgical risk and poor
prognosis.<br/>Copyright &#xa9; 2022 Turkish Society of Cardiology. All
rights reserved.

<29>
Accession Number
2017363063
Title
THE EFFECT OF INHALED MILRINONE ON PULMONARY ARTERIAL PRESSURE IN PATIENTS
UNDERGOING CARDIAC SURGERY.
Source
Journal of Medical Sciences (Peshawar). 30(2) (pp 109-113), 2022. Date of
Publication: 29 Jun 2022.
Author
Anwar K.; Shahkar Ahmed Shah S.; Ehtisham S.
Institution
(Anwar, Shahkar Ahmed Shah) Department of Anesthesia, Peshawar Institute
of Cardiology, KP, Pakistan
(Ehtisham) Department of Cardiothoracic Surgery, Peshawar Institute of
Cardiology, KP, Pakistan
Publisher
Khyber Medical College
Abstract
Objective: To find out the effect of inhaled Milrinone on pulmonary
arterial pressure in patients undergoing cardiac surgery. <br/>Method(s):
A randomized controlled trial was done at Peshawar Institute of Cardiology
in 78 patients who had preoperative pulmonary hypertension and had
undergone cardiac surgery between the ages of 3 months and 60 years.
Divided into 2, group 1 received Intravenous (IV) Milrinone and group 2
received Inhalational (IN) Milrinone. MANOVA was used to compare the
difference between two groups across six dependent variables i.e., Heart
rate (HR), systolic arterial pressure (SAP), Cen-tral venous pressure
(CVP), Systolic pulmonary arterial pressure (SPAP), Diastolic pulmonary
arterial pressure (DPAP) and mean pulmonary arterial pressure (MPAP) at
three stages; baseline, end of nebulization, and after cardiopulmonary
bypass (labeled as stages 1,2 and 3). Intraoperative complications like
weaning from cardiaopulmonary bypass (CPB) machine, use of vasopressor,
insertion of intra-aortic balloon pump (IABP), and cardiopulmonary
re-initiation were also observed in both the groups. Analysis of the data
was done through SPSS-23. <br/>Result(s): In a total of 78 patients (39 in
each group), an insignificant change was observed regarding the effects of
IN Mil-rinone on HR, SAP, and CVP whereas significant effects of Inhaled
Milrinone on SPAP, DPAP, and MPAP were observed (P-values <0.05).
<br/>Conclusion(s): The use of inhaled Milrinone was beneficial in
patients with pulmonary hypertension in the prevention of Intraop-erative
complications like difficulty in weaning from CPB, insertion of IABP, and
use of vasopressors, while CPB re-initiation was observed less in patients
with inhalational milrinone as compared with intravenous administration
while reducing their length of stay in ICU.<br/>Copyright &#xa9; 2022,
Khyber Medical College. All rights reserved.

<30>
Accession Number
2017330662
Title
Heart Function and Ventricular Recovery After Percutaneous Closure of
Perimembranous Ventricular Septal Defect in Children: A Cross-sectional
Study.
Source
Iranian Journal of Pediatrics. 32(3) (no pagination), 2022. Article
Number: e117730. Date of Publication: Jun 2022.
Author
Amoozgar H.; Abdollahi A.; Edraki M.; Mehdizadegan N.; Mohammadi H.; Ajami
G.H.; Naghshzan A.; Abdollahi M.
Institution
(Amoozgar, Mohammadi, Ajami, Naghshzan) The Neonatal Research Center,
Shiraz University of Medical Sciences, Shiraz, Iran, Islamic Republic of
(Abdollahi, Abdollahi) Student Research Committee, Shiraz University of
Medical Sciences, Shiraz, Iran, Islamic Republic of
(Edraki) Department of Pediatrics, Shiraz University of Medical Sciences,
Shiraz, Iran, Islamic Republic of
(Mehdizadegan) The Cardiovascular Research Center, Shiraz University of
Medical Sciences, Shiraz, Iran, Islamic Republic of
Publisher
Brieflands
Abstract
Background: Perimembranous ventricular septal defect (VSD) is the most
common congenital heart defect. There is a trend for percutaneous VSD
closure. However, little evidence is available for the effect of this
method on ventricular remodeling. <br/>Objective(s): This study aimed to
investigate the effect of percutaneous closure of perimembranous VSD on
cardiac function and ventricular recovery. <br/>Method(s): A total of 46
pediatric patients (32 males vs. 14 females) who underwent transcatheter
closure of perimembranous VSD from 2010 to 2020 were randomly included in
the study. Data regarding the demographic profile, angiographic records,
and follow-up echocardiography were extracted from their files and
recorded in questionnaire templates. The echocardiographic parameters were
recorded and compared with published Z-scores for the corresponding age
groups. <br/>Result(s): The mean duration of follow-up was 15.76 +/- 12.20
months. In M-mode echocardiography, 84.6% had interventricular septum
diastolic diameter Z-score >= 2; 23.8% had interventricular septum
systolic diameter Z-score >= 2; 38.5% had left ventricular internal
diameter in diastole Z-score >= 2; 34.6% had left ventricular internal
diameter in systole Z-score >= 2; and 65.4% had left ventricular posterior
wall in diastole Z-score >= 2. In the evaluation of Doppler and tissue
Doppler, 36.4% of the patients had a Z-score >= 2 for E/Ea of tricuspid.
Also, VSD size had a positive correlation with interventricular septal
diameter in systole Z-score (P = 0.015, r = 0.537). <br/>Conclusion(s): In
the midterm follow-up after percutaneous perimembranous VSD closure, left
ventricular dilation and hypertrophy persisted in a significant number of
patients. However, early closure of the VSD, especially in patients with
lower weight could affect ventricular hemodynamics and
remodeling.<br/>Copyright &#xa9; 2022, Author(s).

<31>
Accession Number
2017259590
Title
Relaxin-2 as a Potential Biomarker in Cardiovascular Diseases.
Source
Journal of Personalized Medicine. 12(7) (no pagination), 2022. Article
Number: 1021. Date of Publication: July 2022.
Author
Aragon-Herrera A.; Feijoo-Bandin S.; Anido-Varela L.; Morana-Fernandez S.;
Rosello-Lleti E.; Portoles M.; Tarazon E.; Gualillo O.; Gonzalez-Juanatey
J.R.; Lago F.
Institution
(Aragon-Herrera, Feijoo-Bandin, Anido-Varela, Morana-Fernandez,
Gonzalez-Juanatey, Lago) Cellular and Molecular Cardiology Unit and
Department of Cardiology, Institute of Biomedical Research of Santiago de
Compostela (IDIS-SERGAS), Travesia da Choupana s/n, Santiago de Compostela
15706, Spain
(Aragon-Herrera, Feijoo-Bandin, Rosello-Lleti, Portoles, Tarazon,
Gonzalez-Juanatey, Lago) Network Research Centre for Cardiovascular
Diseases (CIBERCV), Institute of Health Carlos III, C/Monforte de Lemos
3-5, Pabellon 11, Planta 0, Madrid 28029, Spain
(Morana-Fernandez) Cardiology Group, Center for Research in Molecular
Medicine and Chronic Diseases (CIMUS), University of Santiago de
Compostela and Health Research Institute, University Clinical Hospital of
Santiago de Compostela, Avenida Barcelona s/n, Santiago de Compostela
15782, Spain
(Rosello-Lleti, Portoles, Tarazon) Cardiocirculatory Unit, Health
Institute La Fe University Hospital (IIS La Fe), Avda. de Fernando Abril
Martorell, 106, Valencia 46026, Spain
(Gualillo) Laboratory of Neuroendocrine Interactions in Rheumatology and
Inflammatory Diseases, Institute of Biomedical Research (IDIS) and
Xerencia de Xestion Integrada de Santiago de Compostela (XXIS/SERGAS),
Travesia da Choupana s/n, Santiago de Compostela 15706, Spain
Publisher
MDPI
Abstract
The pleiotropic hormone relaxin-2 plays a pivotal role in the physiology
and pathology of the cardiovascular system. Relaxin-2 exerts relevant
regulatory functions in cardiovascular tissues through the specific
receptor relaxin family peptide receptor 1 (RXFP1) in the regulation of
cardiac metabolism; the induction of vasodilatation; the reversion of
fibrosis and hypertrophy; the reduc-tion of inflammation, oxidative
stress, and apoptosis; and the stimulation of angiogenesis, with
in-otropic and chronotropic effects as well. Recent preclinical and
clinical outcomes have encouraged the potential use of relaxin-2 (or its
recombinant form, known as serelaxin) as a therapeutic strategy during
cardiac injury and/or in patients suffering from different cardiovascular
disarrangements, especially heart failure. Furthermore, relaxin-2 has been
proposed as a promising biomarker of cardiovascular health and disease. In
this review, we emphasize the relevance of the endogenous hormone
relaxin-2 as a useful diagnostic biomarker in different backgrounds of
cardiovascular pathol-ogy, such as heart failure, atrial fibrillation,
myocardial infarction, ischemic heart disease, aortic valve disease,
hypertension, and atherosclerosis, which could be relevant in daily
clinical practice and could contribute to comprehending the specific role
of relaxin-2 in cardiovascular diseases.<br/>Copyright &#xa9; 2022 by the
authors. Licensee MDPI, Basel, Switzerland.

<32>
Accession Number
2017259307
Title
One-year outcomes of percutaneous coronary intervention in native coronary
arteries versus saphenous vein grafts in patients with prior coronary
artery bypass graft surgery.
Source
Cardiology Journal. 29(3) (pp 396-404), 2022. Date of Publication: 2022.
Author
Abdelrahman A.; Debski M.; More R.; Abdelaziz H.K.; Choudhury T.;
Eichhofer J.; Patel B.
Institution
(Abdelrahman, Debski, More, Abdelaziz, Choudhury, Eichhofer, Patel)
Department of Cardiology, Lancashire Cardiac Centre, Blackpool Teaching
Hospitals NHS Foundation Trust, Blackpool FY3 8NR, United Kingdom
Publisher
Via Medica
Abstract
Background: Patients with prior coronary artery bypass graft (CABG)
surgery often require percutaneous coronary intervention (PCI). Data are
still limited in regards to the outcomes of native saphenous vein graft
(SVG) PCI after CABG. <br/>Method(s): We performed a retrospective study
in a tertiary reference cardiac center of consecutive patients who
underwent PCI after CABG. The data were collected for patients who
underwent either native or graft PCI from January 2008 to December 2018.
Arterial graft PCIs were excluded. Multivariable Cox regression analysis
with propensity matching was performed, and major adverse cardiac events
(MACE) outcomes including death or myocardial infarction (MI) or
revascularization were assessed at 1-year after each index procedure.
<br/>Result(s): A total of 435 PCI were performed in 401 patients (209 had
native PCI and 192 had graft PCI). Target lesions were classified as
following: 235 (54%) native coronary arteries and 200 (46%) SVG.
Propensity matching resulted in 167 matched pairs. In multivariable Cox
regression graft PCI relative to native PCI was an independent risk factor
for MACE (hazard ratio [HR] 1.725, 95% confidence interval [CI]
1.049-2.837) which was primarily driven by increased incidence in
revascu-larization (HR 2.218, 95% CI 1.193-4.122) and MI (HR 2.248, 95% CI
1.220-4.142) and with no significant difference in mortality (HR 1.118,
95% CI 0.435-2.870). <br/>Conclusion(s): Compared with native coronary
PCI, bypass graft PCI was significantly associated with higher incidence
of MACE at 1-year and this was mainly driven by MI and revascularization.
(Cardiol J 2022; 29, 3: 396-404).<br/>Copyright &#xa9; 2022 Via Medica.

<33>
Accession Number
2017954462
Title
Association of Diabetes Mellitus With Postoperative Complications and
Mortality After Non-Cardiac Surgery: A Meta-Analysis and Systematic
Review.
Source
Frontiers in Endocrinology. 13 (no pagination), 2022. Article Number:
841256. Date of Publication: 26 May 2022.
Author
Zhang X.; Hou A.; Cao J.; Liu Y.; Lou J.; Li H.; Ma Y.; Song Y.; Mi W.;
Liu J.
Institution
(Zhang, Hou, Cao, Liu, Lou, Li, Ma, Song, Mi, Liu) Department of
Anesthesiology, The First Medical Center of Chinese, PLA General Hospital,
Beijing, China
Publisher
Frontiers Media S.A.
Abstract
Background: Although a variety of data showing that diabetes mellitus (DM)
(Type 1 or Type 2) is associated with postoperative complication, there is
still a lack of detailed studies that go through the specific diabetic
subgroups. The goal of this meta-analysis is to assess the relationship
between DM and various complications after non-cardiac surgery.
<br/>Method(s): We searched articles published in three mainstream
electronic databases (PubMed, EMBASE, Web of science) before November,
2020. A random effects model was conducted since heterogeneity always
exist when comparing results between different types of surgery.
<br/>Result(s): This paper included 125 studies with a total sample size
of 3,208,776 participants. DM was a risk factor for any postoperative
complication (Odds ratio (OR)=1.653 [1.487, 1.839]). The risk of
insulin-dependent DM (OR=1.895 [1.331, 2.698]) was higher than that of
non-insulin-dependent DM (OR=1.554 [1.061, 2.277]) for any postoperative
complication. DM had a higher risk of infections (OR=1.537 [1.322,
1.787]), wound healing disorders (OR=2.010 [1.326, 3.046]), hematoma
(OR=1.369 [1.120, 1.673]), renal insufficiency (OR=1.987 [1.311, 3.013]),
myocardial infarction (OR=1.372 [0.574, 3.278]). Meanwhile, DM was a risk
factor for postoperative reoperation (OR=1.568 [1.124, 2.188]),
readmission (OR=1.404 [1.274, 1.548]) and death (OR=1.606 [1.178, 2.191]).
<br/>Conclusion(s): DM is a risk factor for any postoperative
complications, hospitalization and death after non-cardiac surgery. These
findings underscore the importance of preoperative risk factor assessment
of DM for the safe outcome of surgical patients.<br/>Copyright &#xa9; 2022
Zhang, Hou, Cao, Liu, Lou, Li, Ma, Song, Mi and Liu.

<34>
Accession Number
2019582687
Title
Two-lung ventilation in video-assisted thoracoscopic esophagectomy in
prone position: a systematic review.
Source
Anaesthesia Critical Care and Pain Medicine. 41(5) (no pagination), 2022.
Article Number: 101134. Date of Publication: October 2022.
Author
Daghmouri M.A.; Chaouch M.A.; Depret F.; Cattan P.; Plaud B.; Deniau B.
Institution
(Daghmouri, Depret, Plaud, Deniau) Assistance Publique-Hopitaux de Paris
(AP-HP), Groupe Hospitalier St Louis-Lariboisiere, Department of
Anaesthesiology and Critical Care and Burn Unit, Paris, France
(Chaouch) Fattouma Bourguiba Hospital, Department of Visceral Surgery,
Monastir, Tunis
(Depret, Deniau) Institut National de la Sante et de la Recherche Medicale
(INSERM), INSERM UMR-S 942 Mascot, Lariboisiere Hospital, Paris, France
(Cattan) Assistance Publique-Hopitaux de Paris (AP-HP), Groupe Hospitalier
St Louis-Lariboisiere, Department of Digestive Surgery, Paris, France
Publisher
Elsevier Masson s.r.l.
Abstract
Esophageal cancer surgery is still carrying a high risk of morbidity and
mortality. That is why some anesthesia strategies have tried to reduce
those postoperative complications. In this systematic review performed in
accordance with the PRISMA-S guidelines (PROSPERO (ID: CRD42022310385)),
we aimed to investigate the safety and advantages of two-lung ventilation
(TLV) over one-lung ventilation (OLV) in minimally invasive esophagectomy
(MIE) in the prone position. Seven trials, with a total number of 1710
patients (765 patients with TLV versus 945 patients with OLV) were
included. Postoperative mortality and morbidity rates were similar between
TLV and OLV when realised for esophagectomy. Interestingly, we observed no
difference in changes in intraoperative respiratory parameters, operative
duration, thoraco-conversion rate, number of harvested lymph nodes,
postoperative heart rate and respiratory rate between TLV and OLV. TLV
brings better results in terms of intraoperative oxygen arterial pressure
(PaO<inf>2</inf>) during the thoracic time, postoperative oxygenation,
PaO<inf>2</inf> on inspired fraction of oxygen (FiO<inf>2</inf>) ratio,
duration of thoracic surgery, preoperative time, blood loss, temperature
on postoperative day-1, and C-reactive protein dosage. Our study
highlighted the safety of TLV for MIE in prone position when compared to
OLV. Interestingly, we found better intra and postoperative ventilation
parameters. The choice of ventilation modality did not influence clinical
outcome after surgery and the quality of oncological resection. Large
randomised controlled trials are needed to confirm these
results.<br/>Copyright &#xa9; 2022 Societe francaise d'anesthesie et de
reanimation (Sfar)

<35>
Accession Number
2019572525
Title
Balloon- vs Self-Expanding Valve Systems for Failed Small Surgical Aortic
Valve Bioprostheses.
Source
Journal of the American College of Cardiology. 80(7) (pp 681-693), 2022.
Date of Publication: 16 Aug 2022.
Author
Rodes-Cabau J.; Abbas A.E.; Serra V.; Vilalta V.; Nombela-Franco L.;
Regueiro A.; Al-Azizi K.M.; Iskander A.; Conradi L.; Forcillo J.; Lilly
S.; Calabuig A.; Fernandez-Nofrerias E.; Mohammadi S.; Panagides V.;
Pelletier-Beaumont E.; Pibarot P.
Institution
(Rodes-Cabau, Mohammadi, Panagides, Pelletier-Beaumont, Pibarot) Quebec
Heart and Lung Institute, Laval University, Quebec City, QC, Canada
(Abbas) Beaumont Hospital, Royal Oak, MI, United States
(Serra, Calabuig) Hospital Universitari Vall d'Hebron, Barcelona, Spain
(Vilalta, Fernandez-Nofrerias) Hospital Universitari Germans Trias i
Pujol, Badalona, Spain
(Nombela-Franco) Cardiovascular Institute, Hospital Clinico San Carlos,
IdISSC, Madrid, Spain
(Regueiro) Hospital Clinic Barcelona, Barcelona, Spain
(Al-Azizi) Baylor Scott and White The Heart Hospital Plano, Plano, TX,
United States
(Iskander) SJH Cardiology Associates, Syracuse, NY, United States
(Conradi) University Heart and Vascular Center, Hamburg, Germany
(Forcillo) Centre Hospitalier Universitaire de Montreal, Montreal, QC,
Canada
(Lilly) OSU Heart and Vascular Research Organization, Richard M Ross
Hospital, Columbus, OH, United States
Publisher
Elsevier Inc.
Abstract
Background: Data comparing valve systems in the valve-in-valve
transcatheter aortic valve replacement (ViV-TAVR) field have been obtained
from retrospective studies. <br/>Objective(s): The purpose of this study
was to compare the hemodynamic results between the balloon-expandable
valve (BEV) SAPIEN (3/ULTRA, Edwards Lifesciences) and self-expanding
valve (SEV) Evolut (R/PRO/PRO+, Medtronic) in ViV-TAVR. <br/>Method(s):
Patients with a failed small (<=23 mm) surgical valve were randomized to
receive a BEV or an SEV. The primary endpoint was valve hemodynamics
(maximal/mean residual gradients, severe prosthesis patient mismatch
[PPM], or moderate-severe aortic regurgitation) at 30 days as evaluated by
Doppler echocardiography. <br/>Result(s): A total of 102 patients were
randomized, and of these, 98 patients finally underwent a ViV-TAVR
procedure (BEV: n = 46, SEV: n = 52). The procedure was successful in all
cases, with no differences in clinical outcomes at 30 days between groups
(no death or stroke events). Patients in the SEV group exhibited lower
mean and maximal transvalvular gradient values (15 +/- 8 mm Hg vs 23 +/- 8
mm Hg; P < 0.001; 28 +/- 16 mm Hg vs 40 +/- 13 mm Hg, P < 0.001), and a
tendency toward a lower rate of severe PPM (44% vs 64%; P = 0.07). There
were no cases of moderate-severe aortic regurgitation. In total, 55
consecutive patients (SEV: n = 27; BEV: n = 28) underwent invasive valve
hemodynamic evaluation during the procedure, with no differences in mean
and peak transvalvular gradients between both groups (P = 0.41 and P =
0.70, respectively). <br/>Conclusion(s): In patients with small failed
aortic bioprostheses, ViV-TAVR with an SEV was associated with improved
valve hemodynamics as evaluated by echocardiography. There were no
differences between groups in intraprocedural invasive valve hemodynamics
and 30-day clinical outcomes (Comparison of the Balloon-Expandable Edwards
Valve and Self-Expandable CoreValve Evolut R or Evolut PRO System for the
Treatment of Small, Severely Dysfunctional Surgical Aortic Bioprostheses.
The 'LYTEN' Trial; NCT03520101)<br/>Copyright &#xa9; 2022 American College
of Cardiology Foundation

<36>
Accession Number
2019554088
Title
Impact of Continuous Positive Airway Pressure on Postoperative Atrial
Fibrillation in Patients with Obstructive Sleep Apnea Undergoing Coronary
Artery Bypass Graft Surgery: An Exploratory Randomized Multicenter Study.
Source
American Journal of Respiratory and Critical Care Medicine. 206(3) (pp
358-360), 2022. Date of Publication: 01 Aug 2022.
Author
Chalegre S.T.; Barros M.M.; Silva B.P.G.; Furlan S.F.; Giampa S.Q.C.;
Marques J.N.; Albuquerque A.L.T.; Monteiro V.S.; Drager L.F.; Pedrosa R.P.
Institution
(Chalegre, Barros, Silva, Albuquerque, Pedrosa) University of Pernambuco,
Recife, Brazil
(Furlan, Giampa, Drager) Universidade de Sao Paulo, Sao Paulo, Brazil
(Marques, Monteiro) Instituto de Medicina Integral Professor Fernando
Figueira, Recife, Brazil
Publisher
American Thoracic Society

<37>
Accession Number
636226120
Title
Cardiovascular Mortality after Venous Thromboembolism: A Meta-Analysis of
Prospective Cohort Studies.
Source
Seminars in Thrombosis and Hemostasis. 48(4) (pp 481-489), 2022. Date of
Publication: 01 Jun 2022.
Author
Noumegni S.R.; Grangereau T.; Demir A.; Bressollette L.; Couturaud F.;
Hoffmann C.
Institution
(Noumegni, Grangereau, Bressollette, Hoffmann) Department of Vascular
Medicine, Brest Teaching Hospital, Brest University, EA 3878 GETBO, Brest,
France
(Noumegni, Bressollette, Couturaud, Hoffmann) EA3878 (GETBO), Western
Brittany Thrombosis Study Group, Brest University, Brest, France
(Grangereau) Department of Cardiovascular Medicine, Guingamp Hospital,
Guingamp, France
(Demir) Department of Vascular Medicine, Bordeaux Teaching Hospital,
Bordeaux, France
(Couturaud) Department of Internal Medicine and Pneumology, Brest Teaching
Hospital, Brest, France
Publisher
Thieme Medical Publishers, Inc.
Abstract
Many studies from current literature show that cardiovascular diseases in
patients with venous thromboembolism (VTE) are more frequent than in the
general population without VTE. However, data summarizing the impact of
cardiovascular diseases on mortality of patients with VTE are lacking. In
this systematic review and meta-analysis, we aimed to determine the
frequency and incidence rate of cardiovascular death in patients with VTE.
MEDLINE and EMBASE were searched from January 1, 2000 to February 28,
2021. Eligible studies were observational prospective cohort studies
including patients with VTE and reporting all causes of death.
Cardiovascular death was defined as deaths that result from new or
recurrent pulmonary embolism, death due to acute myocardial infarction,
sudden cardiac death or heart failure, death due to stroke, death due to
cardiovascular procedures or hemorrhage, death due to ruptured aortic
aneurysm or aortic dissection and death due to other cardiovascular
causes. Random-effect models meta-analysis served to determine all pooled
effect size of interest with their 95% confidence interval (CI). Thirteen
observational studies enrolling 22,251 patients were identified and
included. The mean/median age varied between 49 and 75 years. The
proportion of men ranged from 38.3 to 53.2%. The overall pooled frequency
of cardiovascular death in patients with VTE was 3.9% (95% CI: 2.5-5.6%),
while the overall pooled frequency of all-cause mortality was 12.0% (95%
CI: 9.1-15.4%). The pooled proportion of cardiovascular death among all
causes of deaths in patients with VTE was 35.2% (95% CI: 22.2-49.3%). The
pooled incidence rate of cardiovascular death was 1.92 per 100
patient-years (95% CI: 0-4.1). The frequency of cardiovascular death in
patients with VTE was significantly higher than in patients without VTE
(risk ratio: 3.85, 95% CI: 2.75-5.39). Based on this updated meta-analysis
from 13 prospective cohort studies, cardiovascular death in patients with
VTE is more frequent than in the general population without
VTE.<br/>Copyright &#xa9; 2022 Thieme Medical Publishers, Inc.. All rights
reserved.

<38>
Accession Number
2014870994
Title
Preoperative heart rate variability as a predictor of perioperative
outcomes: a systematic review without meta-analysis.
Source
Journal of Clinical Monitoring and Computing. 36(4) (pp 947-960), 2022.
Date of Publication: August 2022.
Author
Frandsen M.N.; Mehlsen J.; Foss N.B.; Kehlet H.
Institution
(Frandsen, Mehlsen, Kehlet) Section for Surgical Pathophysiology,
Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
(Foss) Department of Anesthesiology and Intensive Care, Hvidovre
University Hospital, Hvidovre, Denmark
Publisher
Springer Science and Business Media B.V.
Abstract
Heart rate variability (HRV) is a predictor of mortality and morbidity
after non-lethal cardiac ischemia, but the relation between preoperatively
measured HRV and intra- and postoperative complications is sparsely
studied and most recently reviewed in 2007. We, therefore, reviewed the
literature regarding HRV as a predictor for intra- and postoperative
complications and outcomes. We carried out a systematic review without
meta-analysis. A PICO model was set up, and we searched PubMed, EMBASE,
and CENTRAL. The screening was done by one author, but all authors
performed detailed review of the included studies. We present data from
studies on intraoperative and postoperative complications, which were too
heterogeneous to warrant formal meta-analysis, and we provide a pragmatic
review of HRV indices to facilitate understanding our findings. The review
was registered in PROSPERO (CRD42021230641). We screened 2337 records for
eligibility. 131 records went on to full-text assessment, 63 were
included. In frequency analysis of HRV, low frequency to high frequency
ratio could be a predictor for intraoperative hypotension in spinal
anesthesia and lower total power could possibly predict intraoperative
hypotension under general anesthesia. Detrended fluctuation analysis of
HRV is a promising candidate for predicting postoperative atrial
fibrillation. This updated review of the relation between preoperative HRV
and surgical outcome suggests a clinically relevant role of HRV but calls
for high quality studies due to methodological heterogeneity in the
current literature. Areas for future research are suggested.<br/>Copyright
&#xa9; 2022, The Author(s).

<39>
Accession Number
2011602419
Title
Biomarkers of acute kidney injury in pediatric cardiac surgery.
Source
Pediatric Nephrology. 37(1) (pp 61-78), 2022. Date of Publication: January
2022.
Author
Cavalcante C.T.M.B.; Cavalcante M.B.; Castello Branco K.M.P.; Chan T.;
Maia I.C.L.; Pompeu R.G.; de Oliveira Telles A.C.; Brito A.K.M.; Liborio
A.B.
Institution
(Cavalcante, Castello Branco, Maia, Pompeu, de Oliveira Telles, Brito)
Pediatric Cardiac Center of the Messejana Hospital Dr. Carlos Alberto
Studart Gomes, Fortaleza, CE, Brazil
(Cavalcante) Department of Pediatrics, Fortaleza University (UNIFOR), Av.
Washington Soares, 1321 - Edson Queiroz, CEP, Fortaleza, CE 60811-905,
Brazil
(Cavalcante) Department of Obstetrics and Gynecology, Fortaleza University
(UNIFOR), Av. Washington Soares, 1321 - Edson Queiroz, CEP, Fortaleza, CE
60811-905, Brazil
(Chan) The Heart Center, Seattle Children's Hospital, University of
Washington, Seattle, WA, United States
(Cavalcante, Liborio) Medical Sciences Postgraduate Program, Fortaleza
University (UNIFOR), Av. Washington Soares, 1321 - Edson Queiroz, CEP,
Fortaleza, CE 60811-905, Brazil
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Acute kidney injury (AKI) is characterized by a sudden decrease in kidney
function. Children with congenital heart disease are a special group at
risk of developing AKI. We performed a systematic review of the literature
to search for studies reporting the usefulness of novel urine, serum, and
plasma biomarkers in the diagnosis and progression of AKI and their
association with clinical outcomes in children undergoing pediatric
cardiac surgery. In thirty studies, we analyzed the capacity to predict
AKI and poor outcomes of five biomarkers: Cystatin C, Neutrophil
gelatinase-associated lipocalin, Interleukin-18, Kidney injury molecule-1,
and Liver fatty acid-binding protein. In conclusion, we suggest the need
for further meta-analyses with the availability of additional
studies.<br/>Copyright &#xa9; 2021, IPNA.

<40>
Accession Number
2007027586
Title
The Use of Angiotensin II for the Treatment of Post-cardiopulmonary Bypass
Vasoplegia.
Source
Cardiovascular Drugs and Therapy. 36(4) (pp 739-748), 2022. Date of
Publication: August 2022.
Author
Papazisi O.; Palmen M.; Danser A.H.J.
Institution
(Papazisi, Palmen) Department of Cardiothoracic Surgery, Leiden University
Medical Center, Leiden, Netherlands
(Danser) Department of Internal Medicine, Division of Pharmacology,
Erasmus Medical Center, Rotterdam, Netherlands
Publisher
Springer
Abstract
Purpose: Vasoplegia is a common complication after cardiac surgery and is
related to the use of cardiopulmonary bypass (CPB). Despite its
association with increased morbidity and mortality, no consensus exists in
terms of its treatment. In December 2017, angiotensin II (AII) was
approved by the Food and Drug Administration (FDA) for use in vasodilatory
shock; however, except for the ATHOS-3 trial, its use in vasoplegic
patients that underwent cardiac surgery on CPB has mainly been reported in
case reports. Thus, the aim of this review is to collect all the
clinically relevant data and describe the pharmacologic mechanism,
efficacy, and safety of this novel pharmacologic agent for the treatment
of refractory vasoplegia in this population. <br/>Method(s): Two
independent reviewers performed a systematic search in PubMed, Embase, Web
of Science, and Cochrane Library using relevant MeSH terms (Angiotensin
II, Vasoplegia, Cardiopulmonary Bypass, Cardiac Surgical Procedures).
<br/>Result(s): The literature search yielded 820 unique articles. In
total, 9 studies were included. Of those, 2 were randomized clinical
trials (RCTs) and 6 were case reports and 1 was a retrospective cohort
study. <br/>Conclusion(s): AII appears to be a promising means of
treatment for patients with post-operative vasoplegia. It is demonstrated
to be effective in raising blood pressure, while no major adverse events
have been reported. It remains uncertain whether this agent will be
broadly available and whether it will be more advantageous in the clinical
management of vasoplegia compared to other available vasopressors. For
that reason, we should contain our eagerness and enthusiasm regarding its
use until supplementary knowledge becomes available.<br/>Copyright &#xa9;
2020, The Author(s).

<41>
Accession Number
2015117200
Title
Diagnostic accuracy of coronary computed tomography angiography for the
evaluation of obstructive coronary artery disease in patients referred for
transcatheter aortic valve implantation: a systematic review and
meta-analysis.
Source
European Radiology. 32(8) (pp 5189-5200), 2022. Date of Publication:
August 2022.
Author
Gatti M.; Gallone G.; Poggi V.; Bruno F.; Serafini A.; Depaoli A.; De
Filippo O.; Conrotto F.; Darvizeh F.; Faletti R.; De Ferrari G.M.; Fonio
P.; D'Ascenzo F.
Institution
(Gatti, Poggi, Serafini, Depaoli, Faletti, Fonio) Department of Surgical
Sciences, Radiology Unit, University of Turin, Via Genova 3, Turin 10126,
Italy
(Gallone, Bruno, De Filippo, Conrotto, De Ferrari, D'Ascenzo) Division of
Cardiology, Department of Medical Science, University of Turin, Turin,
Italy
(Darvizeh) School of Medicine, Vita-Salute San Raffaele University, Milan
20121, Italy
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Objective: To evaluate the diagnostic accuracy of coronary computed
tomography angiography (CCTA) for the evaluation of obstructive coronary
artery disease (CAD) in patients referred for transcatheter aortic valve
implantation (TAVI). <br/>Method(s): EMBASE, PubMed/MEDLINE, and CENTRAL
were searched for studies reporting accuracy of CCTA for the evaluation of
obstructive CAD compared with invasive coronary angiography (ICA) as the
reference standard. QUADAS-2 tool was used to assess the risk of bias. A
bivariate random effects model was used to analyze, pool, and plot the
diagnostic performance measurements across studies. Pooled sensitivity,
specificity, positive (+ LR) and negative (-LR) likelihood ratio,
diagnostic odds ratio (DOR), and hierarchical summary ROC curve (HSROC)
were evaluated. Prospero registration number: CRD42021252527.
<br/>Result(s): Fourteen studies (2533 patients) were included. In the
intention-to-diagnose patient-level analysis, sensitivity and specificity
for CCTA were 97% (95% CI: 94-98%) and 68% (95% CI: 56-68%), respectively,
and + LR and -LR were 3.0 (95% CI: 2.1-4.3) and 0.05 (95% CI: 0.03 -
0.09), with DOR equal to 60 (95% CI: 30-121). The area under the HSROC
curve was 0.96 (95% CI: 0.94-0.98). No significant difference in
sensitivity was found between single-heartbeat and other CT scanners (96%
(95% CI: 90 - 99%) vs. 97% (95% CI: 94-98%) respectively; p = 0.37),
whereas the specificity of single-heartbeat scanners was higher (82% (95%
CI: 66-92%) vs. 60% (95% CI: 46 - 72%) respectively; p < 0.0001). Routine
CCTA in the pre-TAVI workup could save 41% (95% CI: 34 - 47%) of ICAs if a
disease prevalence of 40% is assumed. <br/>Conclusion(s): CCTA proved an
excellent diagnostic accuracy for assessing obstructive CAD in patients
referred for TAVI; the use of single-heartbeat CT scanners can further
improve these findings. Key Points: * CCTA proved to have an excellent
diagnostic accuracy for assessing obstructive CAD in patients referred for
TAVI. * Routine CCTA in the pre-TAVI workup could save more than 40% of
ICAs. * Single-heartbeat CT scanners had higher specificity than others in
the assessment of obstructive CAD in patients referred for
TAVI.<br/>Copyright &#xa9; 2022, The Author(s).

<42>
[Use Link to view the full text]
Accession Number
2019434957
Title
Understanding Baseline Physical Activity in Cardiac Rehabilitation
Enrollees Using Mobile Health Technologies.
Source
Circulation: Cardiovascular Quality and Outcomes. 15(7) (pp E009182),
2022. Date of Publication: 01 Jul 2022.
Author
Golbus J.R.; Gupta K.; Stevens R.; Jeganathan V.S.; Luff E.; Boyden T.;
Mukherjee B.; Klasnja P.; Kheterpal S.; Kohnstamm S.; Nallamothu B.K.
Institution
(Golbus, Stevens, Jeganathan, Luff, Kheterpal, Nallamothu) Division of
Cardiovascular Diseases, Department of Internal Medicine, University of
Missouri, Kansas City, United States
(Golbus, Nallamothu) Michigan Integrated Center for Health Analytics and
Medical Prediction (MiCHAMP), University of Missouri, Kansas City, United
States
(Mukherjee) School of Public Health, University of Missouri, Kansas City,
United States
(Klasnja) School of Information, University of Missouri, Kansas City,
United States
(Kohnstamm) Department of Anesthesiology, University of Missouri, Kansas
City, United States
(Gupta) University of Missouri, Kansas City, United States
(Boyden, Nallamothu) Division of Cardiovascular Diseases, Department of
Internal Medicine, Spectrum Health, MI, United States
(Nallamothu) The Center for Clinical Management and Research, Ann Arbor VA
Medical Center, MI, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Baseline physical activity in patients when they initiate
cardiac rehabilitation is poorly understood. We used mobile health
technology to understand baseline physical activity of patients initiating
cardiac rehabilitation within a clinical trial to potentially inform
personalized care. <br/>Method(s): The VALENTINE (Virtual
Application-Supported Environment to Increase Exercise During Cardiac
Rehabilitation Study) is a prospective, randomized-controlled, remotely
administered trial designed to evaluate a mobile health intervention to
supplement cardiac rehabilitation for low- and moderate-risk patients. All
participants receive a smartwatch and usual care. Baseline physical
activity was assessed remotely after enrollment and included (1) 6-minute
walk distance, (2) daily step count, and (3) daily exercise minutes, both
over 7 days and for compliant days, defined by >8 hours of watch wear
time. Multivariable linear regression identified patient-level features
associated with these 3 measures of baseline physical activity.
<br/>Result(s): From October 2020 to March 2022, 220 participants enrolled
in the study. Participants are mostly White (184 [83.6%]); 67 (30.5%) are
female and 84 (38.2%) are >65 years old. Most participants enrolled in
cardiac rehabilitation after percutaneous coronary intervention (105
[47.7%]) or coronary artery bypass surgery (39 [17.7 %]). Clinical
diagnoses include coronary artery disease (78.6%), heart failure (17.3%),
and valve repair or replacement (26.4%). Baseline mean 6-minute walk
distance was 489.6 (SD, 143.4) meters, daily step count was 6845 (SD,
3353), and exercise minutes was 37.5 (SD, 33.5). In a multivariable model,
6-minute walk distance was significantly associated with age and sex, but
not cardiac rehabilitation indication. Sex but not age or cardiac
rehabilitation indication was significantly associated with daily step
count and exercise minutes. <br/>Conclusion(s): Baseline physical activity
varies substantially in low- and moderate-risk patients enrolled in
cardiac rehabilitation. Future studies are warranted to explore whether
personalizing cardiac rehabilitation programs using mobile health
technologies could optimize recovery. Registration: URL:
https://www.clinicaltrials.gov; Unique identifier:
NCT04587882.<br/>Copyright &#xa9; 2022 Lippincott Williams and Wilkins.
All rights reserved.

<43>
Accession Number
2019424620
Title
Alpha-2-adrenergic receptor agonists for the prevention of delirium and
cognitive decline after open heart surgery (ALPHA2PREVENT): Protocol for a
multicentre randomised controlled trial.
Source
BMJ Open. 12(6) (no pagination), 2022. Article Number: e057460. Date of
Publication: 01 Jun 2022.
Author
Neerland B.E.; Busund R.; Haaverstad R.; Helbostad J.L.; Landsverk S.A.;
Martinaityte I.; Norum H.M.; Raeder J.; Selbaek G.; Simpson M.R.; Skaar
E.; Skjaervold N.K.; Skovlund E.; Slooter A.J.C.; Svendsen O.S.; Tonnessen
T.; Wahba A.; Zetterberg H.; Wyller T.B.
Institution
(Neerland, Selbaek, Wyller) Department of Geriatric Medicine, Oslo
University Hospital, Oslo, Norway
(Busund) Department of Cardiothoracic and Vascular Surgery, University
Hospital of North Norway, Tromso, Norway
(Busund, Martinaityte) Institute of Clinical Medicine, UiT the Artic
University of Norway, Tromso, Norway
(Haaverstad, Skaar) Department of Heart Disease, Haukeland University
Hospital, Bergen, Norway
(Haaverstad) Institute of Clinical Science, University of Bergen, Bergen,
Norway
(Helbostad) Department of Neuromedicine and Movement Science, Norwegian
University of Science and Technology, Trondheim, Norway
(Landsverk, Norum, Raeder) Department of Anaesthesiology, Oslo University
Hospital, Oslo, Norway
(Martinaityte) Department of Geriatric Medicine, University Hospital of
North Norway, Tromso, Norway
(Norum) Department of Research and Development, Oslo University Hospital,
Oslo, Norway
(Raeder, Selbaek, Tonnessen, Wyller) Institute of Clinical Medicine,
University of Oslo, Oslo, Norway
(Selbaek) Norwegian National Advisory Unit on Ageing and Health, Tonsberg,
Norway
(Simpson, Skovlund) Department of Public Health and Nursing, Norwegian
University of Science and Technology, Trondheim, Norway
(Skjaervold, Wahba) Department of Circulation and Medical Imaging,
Norwegian University of Science and Technology, Trondheim, Norway
(Skjaervold) Department of Anesthesia and Intensive Care Medicine,
Trondheim University Hospital, Trondheim, Norway
(Slooter) Department of Intensive Care Medicine, University Medical Centre
Utrecht, Utrecht, Netherlands
(Slooter) Department of Neurology, Uz Brussel and Vrije Universiteit
Brussel, Brussel, Brussel, Belgium
(Svendsen) Department of Anesthesia and Intensive Care, Haukeland
University Hospital, Bergen, Norway
(Svendsen) Department of Clinical Medicine, University of Bergen, Bergen,
Norway
(Tonnessen) Department of Cardiothoracic Surgery, Oslo University
Hospital, Oslo, Norway
(Wahba) Clinic of Cardiothoracic Surgery, Trondheim University Hospital,
Trondheim, Norway
(Zetterberg) Department of Psychiatry and Neurochemistry, University of
Gothenburg Sahlgrenska Academy, Goteborg, Sweden
(Zetterberg) Department of Neurodegenerative Disease, Ucl Institute of
Neurology, London, United Kingdom
(Zetterberg) Uk Dementia Research Institute, Ucl, London, United Kingdom
(Zetterberg) Hong Kong Center for Neurodegenerative Diseases, Hong Kong
Publisher
BMJ Publishing Group
Abstract
Introduction Postoperative delirium is common in older cardiac surgery
patients and associated with negative short-term and long-term outcomes.
The alpha-2-adrenergic receptor agonist dexmedetomidine shows promise as
prophylaxis and treatment for delirium in intensive care units (ICU) and
postoperative settings. Clonidine has similar pharmacological properties
and can be administered both parenterally and orally. We aim to study
whether repurposing of clonidine can represent a novel treatment option
for delirium, and the possible effects of dexmedetomidine and clonidine on
long-term cognitive trajectories, motor activity patterns and biomarkers
of neuronal injury, and whether these effects are associated with frailty
status. Methods and analysis This five-centre, double-blind randomised
controlled trial will include 900 cardiac surgery patients aged 70+ years.
Participants will be randomised 1:1:1 to dexmedetomidine or clonidine or
placebo. The study drug will be given as a continuous intravenous infusion
from the start of cardiopulmonary bypass, at a rate of 0.4 mug/kg/hour.
The infusion rate will be decreased to 0.2 mug/kg/hour postoperatively and
be continued until discharge from the ICU or 24 hours postoperatively,
whichever happens first. Primary end point is the 7-day cumulative
incidence of postoperative delirium (Diagnostic and Statistical Manual of
Mental Disorders, fifth edition). Secondary end points include the
composite end point of coma, delirium or death, in addition to delirium
severity and motor activity patterns, levels of circulating biomarkers of
neuronal injury, cognitive function and frailty status 1 and 6 months
after surgery. Ethics and dissemination This trial is approved by the
Regional Committee for Ethics in Medical Research in Norway (South-East
Norway) and by the Norwegian Medicines Agency. Dissemination plans include
publication in peer-reviewed medical journals and presentation at
scientific meetings. Trial registration number NCT05029050.<br/>Copyright
&#xa9; 2022 BMJ Publishing Group. All rights reserved.

<44>
Accession Number
2016782134
Title
The Fundamental Role of Stress Echo in Evaluating Coronary Artery Dis-
ease in Specific Patient Populations.
Source
Current Vascular Pharmacology. 20(2) (pp 156-167), 2022. Date of
Publication: March 2022.
Author
Raftopoulos L.; Aggeli C.; Dimitroglou Y.; Kakiouzi V.; Tsartsalis D.;
Patsourakos D.; Tsioufis C.
Institution
(Raftopoulos, Aggeli, Dimitroglou, Kakiouzi, Tsartsalis, Patsourakos,
Tsioufis) First Department of Cardiology, University of Athens Medical
School, General Hospital of Athens Hippokration, Athens, Greece
Publisher
Bentham Science Publishers
Abstract
Stress echocardiography (SE) was initially used for assessing patients
with known or sus-pected coronary heart disease by detecting and
evaluating myocardial ischemia and viability. The implementation of SE has
gradually been extended to several cardiovascular diseases beyond
coro-artery disease (CAD) or other cardiovascular diseases in specific
patient populations. This review attempts to summarize current data
concerning SE implementation and clinical value in these spe- cific and
diverse populations: Patients with an intramural course of a coronary
artery, known as a myocardial bridge, chronic severe or end-stage hepatic
disease, chronic severe or end-stage kidney disease, cardiac allograft
vasculopathy, patients scheduled for solid-organ transplantation and other
intermediate and high-risk surgery and, finally, patients treated with
anticancer drugs or radiothera- py.<br/>Copyright &#xa9; 2022 Bentham
Science Publishers.

<45>
Accession Number
2018273855
Title
Effect of dexmedetomidine for prevention of acute kidney injury after
cardiac surgery: an updated systematic review and meta-analysis.
Source
Renal Failure. 44(1) (pp 1150-1159), 2022. Date of Publication: 2022.
Author
Liu X.; Hu Q.; Chen Q.; Jia J.; Liao Y.-H.; Feng J.
Institution
(Liu, Chen, Liao, Feng) Department of Anesthesiology, The Affiliated
Hospital of Southwest Medical University, Luzhou, China
(Hu) Department of Critical Care Medicine, The Affiliated Hospital of
Southwest Medical University, Luzhou, China
(Jia, Feng) Laboratory of Anesthesiology, The Affiliated Hospital of
Southwest Medical University, Luzhou, China
Publisher
Taylor and Francis Ltd.
Abstract
Background: Acute kidney injury (AKI) is a serious complication related to
cardiac surgery. Several studies have been conducted to investigate the
effect of dexmedetomidine administration on AKI prevention.
<br/>Objective(s): To assess if dexmedetomidine is associated with a
protective effect of renal function after cardiac surgery. And the aim of
conducting this meta-analysis is to summarize the literature and determine
the clinical utility of dexmedetomidine administration in patients
undergoing cardiac surgery. <br/>Method(s): PubMed, Cochrane Library, and
EMBASE databases were comprehensively searched for all randomized
controlled trials (RCTs) published before 1 December, 2021 that
investigated the effect of dexmedetomidine on AKI prevention.
<br/>Result(s): Our analysis included 16 studies involving 2148 patients.
Compared with the control group, dexmedetomidine administration
significantly reduced AKI incidence (OR, 0.47; 95% CI, 0.36-0.61; p <
0.00001; I ² = 26%) and the length of stay in the intensive
care unit (ICU) but did not alter mortality rate, length of stay in the
hospital, and mechanical ventilation time. Furthermore, the incidence of
delirium among patients treated with dexmedetomidine was significantly
decreased. <br/>Conclusion(s): Dexmedetomidine administration has a
positive effect on preventing AKI and postoperative delirium after cardiac
surgery and significantly reduces the length of stay in the
ICU.<br/>Copyright &#xa9; 2022 The Author(s). Published by Informa UK
Limited, trading as Taylor & Francis Group.

<46>
Accession Number
2013963525
Title
Effects of single versus dual antiplatelet therapy on the adverse events
after transcatheter aortic valve implantation: A meta-analysis.
Source
Clinical Cardiology. 44(12) (pp 1718-1728), 2021. Date of Publication:
December 2021.
Author
Yu S.; Zhang S.; Yao C.; Liu J.
Institution
(Yu, Zhang, Yao, Liu) Heart Center, Affiliated Zhongshan Hospital of
Dalian University, Dalian, China
Publisher
John Wiley and Sons Inc
Abstract
Dual antiplatelet therapy (DAPT) was currently recommended for
transcatheter aortic valve implantation (TAVI) postoperative management in
clinical application. However, POPular-TAVI trial showed DAPT increased
the incidence of adverse events compared to single antiplatelet therapy
(SAPT). Herein, we performed a meta-analysis to investigate the effect of
SAPT versus DAPT on the adverse events after TAVI. Eleven studies were
available from PubMed, Embase, Cochrane Library, and Web of Science from
inception to April 1, 2021. The pooled effect size was presented as
relative risk (RR) with 95% confidence intervals (CIs). The sensitivity
analysis was used to assess the stability of analysis results, and Begg's
test was applied to evaluate the publication bias. The Cochran Q test and
the I² statistic were used to evaluate the heterogeneity, and
the source of heterogeneity was explored by meta-regression. A total of
4804 patients were obtained, with 2257 in SAPT group and 2547 in DAPT
group. Compared to the DAPT, SAPT was associated with the decreased risk
of all-cause bleeding (RR: 0.51, 95% CI: 0.44-0.61), major bleeding (RR:
0.53, 95% CI: 0.32-0.86), and minor bleeding (RR: 0.58, 95% CI:
0.34-0.98). There were no significant differences in mortality and
myocardial infarction events, stroke events, and acute kidney injury
between the two groups. SAPT was superior to DAPT in decreasing all-cause
bleeding, major bleeding, and minor bleeding, suggesting that SAPT could
be preferentially recommended for TAVI postoperative management in most
patients without another indication for DAPT and oral
anticoagulation.<br/>Copyright &#xa9; 2021 The Authors. Clinical
Cardiology published by Wiley Periodicals LLC.

<47>
Accession Number
2014191694
Title
Meta-analysis of transcatheter aortic valve implantation versus surgical
aortic valve replacement in patients at low surgical risk.
Source
EuroIntervention. 15(12) (pp E1047-E1056), 2019. Date of Publication:
December 2019.
Author
Witberg G.; Landes U.; Lador A.; Yahav D.; Kornowski R.
Institution
(Witberg, Landes, Lador, Kornowski) Department of Cardiology, Rabin
Medical Center, Petach-Tikva, Israel
(Witberg, Landes, Lador, Yahav, Kornowski) Sackler Faculty of Medicine,
Tel-Aviv University, Tel-Aviv, Israel
(Yahav) Infectious Diseases Unit, Rabin Medical Center, Petach-Tikva,
Israel
Publisher
Europa Group
Abstract
Aims: Although transcatheter aortic valve implantation (TAVI) is
officially indicated for severe aortic stenosis (AS) patients at
intermediate or higher surgical risk, the procedure is now increasingly
being performed in patients who are at low surgical risk. Data on the
benefit of TAVI in this patient population are limited. We therefore aimed
to perform an updated meta-analysis of all published randomised controlled
trials (RCTs) and propensity score-matched studies comparing TAVI versus
surgical aortic valve replacement (SAVR) in patients at low surgical risk.
<br/>Methods and Results: We conducted a systematic review and
meta-analysis of RCTs and observational studies with propensity score
matching (PSM) of TAVI versus SAVR in patients who are at low surgical
risk (mean STS score <4% and/or logistic EuroSCORE <10%). The primary
outcome was mortality (examined at 30 days, one year and the longest
available follow-up). The secondary outcomes included procedural
complications. Nine studies (n=6,124) were included. TAVI was associated
with a numerically, but not statistically, significant reduced mortality
at 30 days (1.45% vs 2.1%, p=0.05), and similar mortality at one year
(5.1% vs 5.0%, p=0.74) and a median of two years (10.8% vs 9.8%, p=0.15).
For both time points, there was significant heterogeneity between RCT/PSM
studies, with the former suggesting survival advantage for TAVI and the
latter for SAVR. In terms of periprocedural complications, TAVI was
associated with reduced risk for stroke, bleeding and renal failure and an
increase in vascular complications and pacemaker implantation.
<br/>Conclusion(s): In patients who are at low surgical risk, TAVI seems
to be associated with equivalent mortality up to a median follow-up of two
years compared to SAVR. More data are required before TAVI can be
routinely considered as an alternative to SAVR in low-risk
patients.<br/>Copyright &#xa9; Europa Digital & Publishing 2019.

<48>
Accession Number
638033222
Title
Apixaban vs. standard of care after transcatheter aortic valve
implantation: the ATLANTIS trial.
Source
European heart journal. 43(29) (pp 2783-2797), 2022. Date of Publication:
01 Aug 2022.
Author
Collet J.P.; Van Belle E.; Thiele H.; Berti S.; Lhermusier T.; Manigold
T.; Neumann F.J.; Gilard M.; Attias D.; Beygui F.; Cequier A.; Alfonso F.;
Aubry P.; Baronnet F.; Ederhy S.; Kasty M.E.; Kerneis M.; Barthelemy O.;
Lefevre T.; Leprince P.; Redheuil A.; Henry P.; Portal J.J.; Vicaut E.;
Montalescot G.
Institution
(Collet, Kerneis, Barthelemy, Montalescot) Sorbonne Universite, ACTION
Group, INSERM UMRS 1166, Hopital Pitie-Salpetriere (AP-HP), Institut de
Cardiologie, Paris 75013, France
(Van Belle) Pole Cardiovasculaire et Pulmonaire, ACTION Group, Inserm
U1011, Institut Pasteur de Lille, EGID, Universite de Lille, CHU Lille,
Lille, France
(Thiele) Department of Internal Medicine/Cardiology, Heart Center Leipzig
at University of Leipzig and Leipzig, Leipzig, Germany
(Berti) Fondazione Toscana G. Monasterio, Ospedale del Cuore G, Massa,
Italy
(Lhermusier) Hopital de Rangueil, Federation de Cardiologie, Pole
Cardio-vasculaire et Metabolique, Toulouse, France
(Manigold) Hopital Guillaume et Rene Laennec, Unite Hemodynamique et
Cardiovasculaire Interventionnel, Nantes, France
(Neumann) University Heart Centre Freiburg Bad Krozingen, Division of
Cardiology and Angiology II, Bad Krozingen, Germany
(Gilard) CHU Brest, Departement de Cardiologie, Brest, France
(Attias) Centre Cardiologique du Nord, Saint Denis, France
(Beygui) CHU de la Cote de Nacre, Departement de Cardiologie, Caen, France
(Cequier) Hospital Universitario de Bellvitge, University of Barcelona,
Heart Disease Institute, L'Hospitalet de Llobregat, Barcelona, Spain
(Alfonso) Hospital Universitario de la Princesa, Department of Cardiology,
Madrid, Spain
(Aubry) Centre Hospitalier Bichat, Departement de Cardiologie, Paris,
France
(Baronnet) Hopital La Pitie-Salpetriere (AP-HP), Unite Intensif de
Neurologie Vasculaire, Paris, France
(Ederhy) Hopital Saint-Antoine (AP-HP), ACTION Group, Service de
Cardiologie, Paris, France
(Kasty) Hopital de Jossigny, ACTION Group, Service de Cardiologie,
Jossigny, France
(Lefevre) Hopital Prive Jacques Cartier, Institut Cardiovasculaire Paris
Sud, Massy, France
(Leprince) Institut de Cardiologie, Chirurgie Cardiaque, Paris, France
(Redheuil) Laboratoire Imagerie Biomedicale (LIB), ICAN, ACTION Group,
Hopital Pitie-Salpetriere (AP-HP), Institut de Cardiologie, Sorbonne
Universite, Paris, France
(Henry) Hopital Lariboisiere (AP-HP), Service de Cardiologie, Universite
de Paris, Paris, France
(Portal, Vicaut) Unite de Recherche Clinique Lariboisiere St Louis, ACTION
Group, Paris, France
Publisher
NLM (Medline)
Abstract
AIMS: The respective roles of oral anticoagulation or antiplatelet therapy
following transcatheter aortic valve implantation (TAVI) remain debated.
ATLANTIS is an international, randomized, open-label, superiority trial
comparing apixaban to the standard of care. METHODS AND RESULTS: After
successful TAVI, 1500 patients were randomized (1:1) to receive apixaban 5
mg (2.5 mg if impaired renal function or concomitant antiplatelet therapy)
(n=749) twice daily, or standard of care (n=751). Randomization was
stratified by the need for chronic anticoagulation therapy.
Standard-of-care patients received a vitamin K antagonist (VKA) (Stratum
1) or antiplatelet therapy (Stratum 2) if there was an indication for
anticoagulation or not, respectively. The primary endpoint was the
composite of death, myocardial infarction, stroke or transient ischaemic
attack, systemic embolism, intracardiac or bioprosthesis thrombosis, deep
vein thrombosis or pulmonary embolism, and life-threatening, disabling, or
major bleeding over 1-year follow-up. The primary safety endpoint was
major, disabling, or life-threatening bleeding. The primary outcome
occurred in 138 (18.4%) and 151 (20.1%) patients receiving apixaban or
standard of care, respectively [hazard ratio (HR) 0.92; 95% confidence
interval (CI) 0.73-1.16] and there was no evidence of interaction between
treatment and stratum (Pinteraction=0.57). The primary safety endpoint was
similar in both groups (HR 1.02; 95% CI 0.72-1.44). In Stratum 1 (n=451),
an exploratory analysis showed no difference for all endpoints between
apixaban and VKA. In Stratum 2 (n=1049), the primary outcome and primary
safety endpoint did not differ, but obstructive valve thrombosis was
reduced with apixaban vs. antiplatelet therapy (HR 0.19; 95% CI
0.08-0.46), while a signal of higher non-cardiovascular mortality was
observed with apixaban. <br/>CONCLUSION(S): After TAVI, apixaban was not
superior to the standard of care, irrespective of an indication for oral
anticoagulation.<br/>Copyright &#xa9; The Author(s) 2022. Published by
Oxford University Press on behalf of European Society of Cardiology. All
rights reserved. For permissions, please e-mail:
journals.permissions@oup.com.

<49>
Accession Number
637994718
Title
Timing of cardiac surgery during pregnancy: a patient-level meta-analysis.
Source
European heart journal. 43(29) (pp 2801-2811), 2022. Date of Publication:
01 Aug 2022.
Author
van Steenbergen G.J.; Tsang Q.H.Y.; van der Heijden O.W.H.; Vart P.;
Rodwell L.; Roos-Hesselink J.W.; van Kimmenade R.R.J.; Li W.W.L.; Verhagen
A.F.T.M.
Institution
(van Steenbergen, Tsang, Li, Verhagen) Department of Cardiothoracic
Surgery, Radboud University Medical Centre, P.O. Box 9101, HB Nijmegen
6500, Netherlands
(van der Heijden) Department of Obstetrics and Gynaecology, Radboud
University Medical Centre, P.O. Box 9101, HB Nijmegen 6500, Netherlands
(Vart, van Kimmenade) Department of Cardiology, Radboud University Medical
Centre, P.O. Box 9101, HB Nijmegen 6500, Netherlands
(Rodwell) Radboud Institute for Health Sciences, Health Evidence, Section
Biostatistics, Nijmegen, Netherlands
(Roos-Hesselink) Department of Cardiology, Erasmus University Medical
Centre, Box 2040, 3000 CA Rotterdam, The Netherlands
Publisher
NLM (Medline)
Abstract
AIMS: To investigate the association between the timing of cardiac surgery
during pregnancy and both maternal and foetal outcomes. METHODS AND
RESULTS: Studies published up to 6 February 2021 on maternal and/or foetal
mortality after cardiac surgery during pregnancy that included individual
patient data were identified. Maternal and foetal mortality was analysed
per trimester for the total population and stratified for patients who
underwent caesarean section (CS) prior to cardiac surgery (Caesarean
section (CaeSe) group) vs. patients who did not (Cardiac surgery (CarSu)
group). Multivariable logistic regression analysis was performed to
evaluate predictors of both maternal and foetal mortality. In total, 179
studies were identified including 386 patients of which 120 underwent CS
prior to cardiac surgery. Maternal mortality was 7.3% and did not differ
significantly among trimesters of pregnancy (P=0.292) nor between subgroup
CaeSe and CarSu (P=0.671). Overall foetal mortality was 26.5% and was
lowest when cardiac surgery was performed during the third trimester
(10.3%, P<0.01). CS prior to surgery was significantly associated with a
reduced risk of foetal mortality in a multivariable model [odds ratio
0.19, 95% confidence interval [0.06-0.56)]. Trimester was not identified
as an independent predictor for foetal nor maternal mortality.
<br/>CONCLUSION(S): Maternal mortality after cardiac surgery during
pregnancy is not associated with the trimester of pregnancy. Cardiac
surgery is associated with high foetal mortality but is significantly
lower in women where CS is performed prior to cardiac surgery. When the
foetus is viable, CS prior to cardiac surgery might be safe. When CS is
not feasible, trimester stage does not seem to influence foetal
mortality.<br/>Copyright &#xa9; The Author(s) 2022. Published by Oxford
University Press on behalf of the European Society of Cardiology. All
rights reserved. For permissions, please email:
journals.permissions@oup.com.

<50>
Accession Number
637540331
Title
Two-lung ventilation or one-lung ventilation for esophagectomy: maybe the
more is better from the evidence of meta-analysis.
Source
Updates in surgery. 74(4) (pp 1199-1207), 2022. Date of Publication: 01
Aug 2022.
Author
Deng H.-Y.; Zhang Y.; Ren Y.; Xu Y.; Tang X.
Institution
(Deng, Tang) Lung Cancer Center, West China Hospital, Sichuan University,
No. 37 Guoxue Street, Chengdu, Sichuan 610041, China
(Zhang, Xu) Department of Anesthesiology, West China Hospital, Sichuan
University and The Research Units of West China (2018RU012), Chinese
Academy of Medical Sciences, Chengdu 610041, China
(Ren) Department of Outpatient, West China Hospital, Sichuan University,
Chengdu 610041, China
Publisher
NLM (Medline)
Abstract
One-lung ventilation (OLV) is the most commonly used ventilation strategy
during esophagectomy. However, two-lung ventilation (TLV) with artificial
pneumothorax has been applied in recent years during esophagectomy. It is
unclear whether TLV takes advantages over OLV for esophagectomy. Here, we
conducted a meta-analysis to compare the effects of TLV and OLV for
esophagectomy. We searched relevant studies from the Cochrane Central
Register of Controlled Trials, Pubmed, and Embase in November 2020. We
included studies that compared the effects of TLV with OLV in
esophagectomy and provided sufficient perioperative and postoperative
data. We extracted data of postoperative outcomes (postoperative pulmonary
complications, anastomotic leak, hospital stay) and surgical variables
(thoracic phrase time, blood loss, the number of total resected thoracic
lymph nodes). We calculated the risk ratio (RR) for dichotomous data and
the weighted mean differences (WMDs) for continuous data. Six studies with
1725 patients were included in this meta-analysis. TLV was associated with
significantly lower incidence of postoperative pulmonary complications
[RR=0.714; 95% confidence interval (CI)=(0.534, 0.956); P=0.023], shorter
hospital stay [WMD=-0.148; 95% CI=(-0.246,-0.051); P=0.003], less blood
loss [WMD=-0.352; 95% CI=(-0.528,-0.176); P<0.001] and more resected
thoracic lymph nodes [WMD=0.207; 95% CI=(0.003, 0.4120); P=0.047] than
OLV. Moreover, TLV consumed similar time for thoracic phrase [WMD=-0.289;
95% CI=(-0.661, 0.083); P=0.128], and yielded a comparable rate of
anastomotic leak [RR=1.086; 95% CI=(0.842, 1.400); P=0.525] compared with
OLV. TLV with artificial pneumothorax resulted in less trauma than OLV.
TLV with artificial pneumothorax is safe and could be a choice of
ventilation strategy for esophagectomy.<br/>Copyright &#xa9; 2022. Italian
Society of Surgery (SIC).

<51>
Accession Number
2016733714
Title
Autologous red blood cell transfusion does not result in a more profound
increase in pulmonary capillary wedge pressure compared to saline in
critically ill patients: A randomized crossover trial.
Source
Vox Sanguinis. 117(8) (pp 1035-1042), 2022. Date of Publication: August
2022.
Author
Bosboom J.J.; Klanderman R.B.; Terwindt L.E.; Bulle E.B.; Wijnberge M.;
Eberl S.; Driessen A.H.; Winkelman T.A.; Geerts B.F.; Veelo D.P.; Hollmann
M.W.; Vlaar A.P.J.
Institution
(Bosboom, Klanderman, Terwindt, Wijnberge, Eberl, Veelo, Hollmann)
Department of Anesthesiology, Amsterdam UMC, University of Amsterdam,
Amsterdam, Netherlands
(Bosboom, Klanderman, Bulle, Wijnberge, Vlaar) Department of Intensive
Care, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
(Klanderman, Wijnberge, Hollmann, Vlaar) Laboratory of Experimental
Intensive Care and Anesthesiology, Amsterdam UMC, University of Amsterdam,
Amsterdam, Netherlands
(Driessen, Winkelman) Department of Cardiothoracic Surgery, Amsterdam UMC,
University of Amsterdam, Amsterdam, Netherlands
(Geerts) Healthplus.ai-R&D B.V., Amsterdam, Netherlands
Publisher
John Wiley and Sons Inc
Abstract
Background and Objectives: Transfusion-associated circulatory overload
(TACO) is a major cause of severe transfusion-related morbidity.
Transfusion of red blood cells (RBCs) has been shown to induce hydrostatic
pressure overload. It is unclear which product-specific factors
contribute. We set out to determine the effect of autologous RBC
transfusion versus saline on pulmonary capillary wedge pressure (PCWP)
change. <br/>Material(s) and Method(s): In a randomized crossover trial,
patients who had undergone coronary bypass surgery were allocated to
treatment post-operatively in the intensive care unit with either an
initial 300 ml autologous RBC transfusion (salvaged during surgery) or 300
ml saline infusion first, followed by the other. Primary outcome was the
difference in PCWP change. Secondary outcome measures were the difference
in extra-vascular lung water index (EVLWI) and pulmonary vascular
permeability index (PVPI). <br/>Result(s): Change in PCWP was not higher
after autologous RBC transfusion compared to saline (DELTAPCWP 0.3 +/- 0.4
vs. 0.1 +/- 0.4 mmHg). DELTAEVLWI and DELTAPVPI were significantly
decreased after autologous RBC transfusion compared to saline (DELTAEVLWI
-1.6 +/- 0.6 vs. 0.2 +/- 0.4, p = 0.02; DELTAPVPI -0.3 +/- 0.1 vs. 0.0 +/-
0.1, p = 0.01). Haemodynamic variables and colloid osmotic pressure were
not different for autologous RBC transfusion versus saline.
<br/>Conclusion(s): Transfusion of autologous RBCs did not result in a
more profound increase in PCWP compared to saline. RBC transfusion
resulted in a decrease of EVLWI and PVPI compared to saline. Our data
suggest that transfusing autologous RBCs may lead to less pulmonary oedema
compared to saline. Future studies with allogeneic RBCs are needed to
investigate other factors that may mediate the increase of PCWP, resulting
in TACO.<br/>Copyright &#xa9; 2022 The Authors. Vox Sanguinis published by
John Wiley & Sons Ltd on behalf of International Society of Blood
Transfusion.

<52>
Accession Number
2019540199
Title
Eicosapentaenoic Acid for Cardiovascular Events Reduction- Systematic
Review and Network Meta-Analysis of Randomized Controlled Trials: EPA and
cardiovascular outcomes.
Source
Journal of Cardiology. (no pagination), 2022. Date of Publication: 2022.
Author
Yokoyama Y.; Kuno T.; Morita S.X.; Slipczuk L.; Takagi H.; Briasoulis A.;
Latib A.; Bangalore S.; Heffron S.P.
Institution
(Yokoyama) Department of Surgery, St. Luke's University Health Network,
Bethlehem, PA, United States
(Kuno) Department of Medicine, Icahn School of Medicine at Mount Sinai,
Mount Sinai Beth Israel, New York, NY, United States
(Kuno, Slipczuk, Latib) Division of Cardiology, Montefiore Medical Center,
Albert Einstein College of Medicine, New York, NY, United States
(Morita) Division of Cardiology, Department of Medicine, Columbia
University Irving Medical Center/New York-Presbyterian Hospital, New York,
NY, United States
(Takagi) Department of Cardiovascular Surgery, Medical Center, Sunto-gun,
Shizuoka, Shizuoka, Japan
(Briasoulis) Division of Cardiovascular Diseases, University of Iowa
Hospitals and Clinics, Iowa City, IA, United States
(Bangalore, Heffron) Leon H. Charney Division of Cardiology, Department of
Medicine, NYU Grossman School of Medicine, New York, NY, United States
(Heffron) NYU Center for the Prevention of Cardiovascular Disease, New
York Langone Health, New York, NY, United States
Publisher
Japanese College of Cardiology (Nippon-Sinzobyo-Gakkai)
Abstract
Background: Randomized clinical trials (RCTs) investigating the impact of
omega-3-fatty acid supplementation on cardiovascular events have largely
shown no benefit. However, there is debate about the benign nature of the
placebo in these trials. We aimed to conduct a network meta-analysis of
RCTs to compare the outcomes of omega-3 fatty acid supplementation to
various placebo oils. <br/>Method(s): MEDLINE and EMBASE were searched
through May, 2021 to identify RCTs investigating cardiovascular outcomes
with omega-3-fatty acid formulations [eicosapentaenoic acid (EPA),
decosahexanoic acid (DHA), or the combination] versus placebo or standard
of care controls. <br/>Result(s): Our analysis included 17 RCTs that
enrolled a total of 141,009 patients randomized to EPA (n=13,655), EPA+DHA
(n=56,908), mineral oil placebo (n=5,338), corn oil placebo (n =8,876),
olive oil placebo (n=41,009), and controls (no placebo oil; n=15,223).
Rates of cardiovascular death [hazard ratio (HR) (95% confidence interval,
CI) =0.80 (0.65-0.98); p =0.033], myocardial infarction [HR (95% CI) =0.73
(0.55-0.97); p=0.029] and stroke [HR (95% CI) =0.74 (0.58-0.94); p=0.014]
were significantly lower in those receiving EPA compared to those
receiving mineral oil, but were not different from rates in those
receiving other oils or controls. Rates of coronary revascularization were
significantly lower in those receiving EPA than in those receiving either
EPA+DHA, mineral oil, corn oil, or olive oil placebo, but not controls.
All-cause death was similar among all groups, but combined EPA+DHA was
associated with reduced risk of cardiovascular death compared to controls
[HR (95%CI): 0.83 (0.71-0.98)]. <br/>Conclusion(s): Our analyses
demonstrate that although EPA supplementation lowers risk of coronary
revascularization more than other oils, there may not be a benefit
relative to standard of care. Further, EPA reduces the risk of
cardiovascular events only in comparison to mineral oil and not when
compared with other placebo oils or controls. In contrast, combined
EPA+DHA was associated with reduced risk of cardiovascular death compared
to controls.<br/>Copyright &#xa9; 2022 Elsevier Ltd

<53>
Accession Number
2002288970
Title
Meta-Analysis Comparing the Risk of Myocardial Infarction Following
Coronary Artery Bypass Grafting Versus Percutaneous Coronary Intervention
in Patients With Multivessel or Left Main Coronary Artery Disease.
Source
American Journal of Cardiology. 124(6) (pp 842-850), 2019. Date of
Publication: 15 Sep 2019.
Author
Lee P.H.; Park H.; Lee J.S.; Lee S.-W.; Lee C.W.
Institution
(Lee, Park, Lee, Lee) Division of Cardiology, Department of Internal
Medicine, Asan Medical Center, University of Ulsan College of Medicine,
Seoul, South Korea
(Lee) Department of Clinical Epidemiology and Biostatistics, Asan Medical
Center, University of Ulsan College of Medicine, Seoul, South Korea
(Lee) Clinical Research Center, Asan Institute for Life Sciences, Asan
Medical Center, University of Ulsan College of Medicine, Seoul, South
Korea
Publisher
Elsevier Inc.
Abstract
There is insufficient data regarding the comparative efficacy of coronary
artery bypass graft surgery (CABG) and percutaneous coronary intervention
(PCI) regarding myocardial infarction (MI). Our systematic review included
randomized controlled trials that compared CABG versus PCI with stents in
patients with multivessel or left main coronary artery disease (CAD).
Included trials should have had reported event number of MI and a clinical
follow-up of one or more years. Data were pooled using a random-effects
model. The primary end point was MI at the longest available follow-up in
the intention-to-treat population. Fifteen trials with a total of 13,592
patients treated with either CABG (n = 6,596) or PCI (n = 6,996) were
included. After a weighted follow-up of 4.5 years, patients treated with
CABG had a significantly lower risk of MI than those treated with PCI
(risk ratio [RR] 0.75, 95% confidence interval [CI] 0.58 to 0.96, p =
0.024). The lower risk of MI with CABG as compared with PCI was more
evident during a longer duration of follow-up (>=3 years, RR 0.69, 95% CI
0.52 to 0.91, p = 0.008; >=5 years, RR 0.64, 95% CI 0.48 to 0.86, p =
0.003) and in the diabetic population (RR 0.55, 95% CI 0.44 to 0.70, p
<0.001). The magnitude of risk reduction was similar across patients with
multivessel (RR 0.72, 95% CI 0.53 to 0.99) and left main CAD (RR 0.74, 95%
CI 0.47 to 1.15). In conclusion, the present meta-analysis of studies
involving patients with multivessel or left main CAD suggests a
significant benefit of CABG over PCI concerning the risk of future
MI.<br/>Copyright &#xa9; 2019 Elsevier Inc.

<54>
Accession Number
2019557676
Title
Is Transcatheter Aortic Valve Implantation (TAVI) Associated With
Improvement in Quality of Life? A Systematic Review.
Source
Heart Lung and Circulation. Conference: 70th Annual Scientific Meeting of
the Cardiac Society of Australia and New Zealand. Broadbeach Australia.
31(Supplement 3) (pp S249), 2022. Date of Publication: January 2022.
Author
Pollock M.; Driscoll A.; Hutchinson A.
Institution
(Pollock, Driscoll, Hutchinson) Deakin University, Burwood, Australia
Publisher
Elsevier Ltd
Abstract
TAVI has become a common treatment for severe aortic stenosis (AS) in
patients who are unsuitable for surgical AVR, but quality of life (QoL)
outcomes remain unclear. The aim of this systematic review was to answer
the question, in patients with AS is TAVI associated with improvement in
QoL? This review was conducted in accordance with the Cochrane systematic
review guidelines. We searched Medline, CINAHL, PSYCHInfo, and EMBASE for
eligible articles from 1/1/2000 to 2/11/2021. Search strategies were
developed for each database. No geographic or language limiters were used
in the search strategy. Conference abstracts, case reports and case series
were excluded. We included any paper which assessed QoL in TAVI patients
pre- and postoperatively using either a qualitative interview or a
validated QoL assessment instrument. Papers not in English or focussing on
paediatric populations were excluded in the screening stage. 50 studies
were included from a pool of 3838 papers. In general, TAVI was found to
result in an improvement in QoL post-procedure, regardless of the QoL
assessment instrument or follow-up time period; qualitative interviews
provided more nuance and suggested a modest improvement in some, but not
all, aspects of QoL. However, it was extremely difficult to compare papers
meaningfully due to the wide variety of instruments and measurement time
points used. The overall quality of the evidence was moderate. The results
suggest that a consistent approach to QoL assessment in TAVI research
would result in clearer and easier to compare QoL outcomes.<br/>Copyright
&#xa9; 2022

<55>
Accession Number
2019557602
Title
Cardiovascular Outcomes of Metabolic Surgery: A Systematic Review and
Meta-Analysis.
Source
Heart Lung and Circulation. Conference: 70th Annual Scientific Meeting of
the Cardiac Society of Australia and New Zealand. Broadbeach Australia.
31(Supplement 3) (pp S289-S290), 2022. Date of Publication: January 2022.
Author
Hay M.; Salib A.; Nelson A.; Nerlekar N.
Institution
(Hay, Salib, Nelson, Nerlekar) Monash Heart, Clayton, VIC, Australia
Publisher
Elsevier Ltd
Abstract
Background: Obesity remains a major public health issue responsible for
significant cardiovascular morbidity. Metabolic surgery reduces obesity
and improves mortality, however studies have not been powered for, or
presented specific cardiovascular (CV) outcomes. We performed an updated
meta-analysis to examine this. <br/>Method(s): Studies comparing metabolic
surgery with controls were identified through online databases and
included if they had >4year follow-up, >200 patients and reported total
mortality or CV outcomes: (CV mortality, myocardial infarction (MI), New
heart failure (HF), HF hospitalisation or stroke). Random effects analysis
with hazard ratio's (HR) as effect sizes and respective 95% confidence
intervals (95%CI) was performed. Meta-regression to assess effects of
independent variables (CV risk factors, surgery type, study design) on
effect size in unadjusted reported values was performed. <br/>Result(s):
30 studies met inclusion criteria (total population 417,791, median
follow-up 4.9 years, 32% males, mean BMI 43.8 +/- 3). In 22 studies
reporting mortality the pooled HR was 0.54 (95%CI 0.46-0.63, p<0.001). CV
mortality (6 studies, HR 0.53, 95%CI 0.30-0.92, p=0.02); MI (11 studies,
HR 0.54, 95%CI 0.42-0.70, p<0.001); New HF (6 studies, HR 0.55, 95%CI
0.42-0.71, p<0.001); HF hospitalisation (4 studies, HR 0.41, 95%CI
0.35-0.49, p<0.001) and Stroke (HR 0.80, 95%CI 0.69-0.93, p=0005).
Meta-regression demonstrated no significant variables associated with
effect size, but there was a beneficial trend for secondary prevention.
<br/>Conclusion(s): Metabolic surgery significantly improves CV outcomes.
Specific factors that influence these outcomes remain uncertain with a
trend toward significance for secondary preventive cohorts. Further study
in specified patient groups is needed.<br/>Copyright &#xa9; 2022

<56>
Accession Number
2019556601
Title
Exploring Variability in Monitoring for and Diagnosing Post-Operative
Atrial Fibrillation After Coronary Revascularisation Surgery: A Scoping
Review.
Source
Heart Lung and Circulation. Conference: 70th Annual Scientific Meeting of
the Cardiac Society of Australia and New Zealand. Broadbeach Australia.
31(Supplement 3) (pp S257), 2022. Date of Publication: January 2022.
Author
Higgs M.; McDonagh J.; Sim J.
Institution
(Higgs, McDonagh, Sim) School of Nursing and Midwifery, University of
Newcastle, Central Coast, Newcastle, NSW, Australia
Publisher
Elsevier Ltd
Abstract
Background: Atrial fibrillation (AF) is the most commonly reported
complication following coronary revascularisation surgery. The reported
incidence rates and clinical practices for monitoring for and diagnosing
post-operative atrial fibrillation (POAF) are highly variable amongst
published literature. <br/>Objective(s): This scoping review sought to
explore variability in clinical practice related to POAF diagnosis
following coronary revascularisation surgery. <br/>Method(s): The
Preferred Reporting Items for Systematic Reviews and Meta-analyses
extension for Scoping Reviews (PRISMA-ScR) guided the review. CINAHL,
MEDLINE and ProQuest were searched to identify relevant published
literature. Limits included papers published in English that included
human participants over the age of 18. No date or study design limits were
imposed. Eligibility screening and data extraction was conducted by one
reviewer. <br/>Result(s): A total of 534 papers were identified. Following
the deletion of duplicates and application of inclusion and exclusion
criteria 79 studies were included. The duration of time that a run of AF
was required to be sustained to reach a diagnosis of POAF, ranged from 30
seconds to greater than 1 hour. A high level of variance was also
identified in practices related to postoperative telemetry monitoring and
the frequency of conducting postoperative twelve-lead electrocardiograms.
The duration of continuous rhythm monitoring ranged from 24 hours to 5
days (up until day of discharge). <br/>Conclusion(s): There is a lack of
consistency regarding the diagnosis of POAF following coronary
revascularisation surgery. Consensus and standardisation of clinical
practices is urgently needed. This will enable future research to focus on
examining the pre-disposing factors of POAF.<br/>Copyright &#xa9; 2022

<57>
Accession Number
2019554448
Title
Cardiac Resynchronisation Therapy in Adult Congenital Heart Disease: A
Review of the Literature.
Source
Heart Lung and Circulation. Conference: 70th Annual Scientific Meeting of
the Cardiac Society of Australia and New Zealand. Broadbeach Australia.
31(Supplement 3) (pp S265), 2022. Date of Publication: January 2022.
Author
Makarious D.; Choudhary P.
Institution
(Makarious, Choudhary) Westmead Hospital Department of Cardiology,
Westmead, NSW, Australia
(Choudhary) Blacktown Hospital Department of Cardiology, Blacktown, NSW,
Australia
Publisher
Elsevier Ltd
Abstract
Introduction: The use of cardiac resynchronisation therapy (CRT) in
patients with adult congenital heart disease (ACHD) has not yet been
validated in randomised control trials (RCTs). Significant heterogeneity
within this cohort prevents inclusion in RCTs. CRT has theoretical
benefits in ACHD patients given their predisposition to ventricular
dyssynchrony and heart failure. <br/>Method(s): We performed a literature
review of medical databases including PubMed, EMBASE and the Cochrane
library to identify patients with ACHD in whom a CRT device was implanted.
We excluded patients <18 years of age, patients undergoing concomitant
cardiac surgery and studies without reported outcomes. <br/>Result(s): 32
studies were eligible, identifying 182 patients. Of these 48.3% (n=88) had
a systemic right ventricle (sRV), 32.4% (n=59) had a systemic left
ventricle (sLV), 17.6% (n=32) had tetralogy of Fallot and 1.6% (n=3) had a
single ventricle. Patients were predominantly NYHA class II (33.59%) and
NYHA class III (57.81%) at time of device insertion with an average QRS
duration of 182.4ms (SD 46.9ms). There was a 75% (n=137) response rate to
CRT insertion, with a response defined as improvement in NYHA class and/or
systemic ventricular ejection fraction. On average the QRS narrowed by
21.6% (SD 15.07). Systemic ejection fraction improved by 8.83% (SD 6.94)
in sRV patients and 18.06% (SD 10.59) in sLV patients. <br/>Conclusion(s):
There was a positive signal regarding the benefits of CRT in ACHD patients
with heart failure. Although no RCTs have been performed, the data does
suggest benefit in the use of CRT in this population.<br/>Copyright &#xa9;
2022

<58>
Accession Number
2019554386
Title
Midodrine to Treat Protein-Losing Enteropathy for Heart Transplant
Candidacy.
Source
Heart Lung and Circulation. Conference: 70th Annual Scientific Meeting of
the Cardiac Society of Australia and New Zealand. Broadbeach Australia.
31(Supplement 3) (pp S90), 2022. Date of Publication: January 2022.
Author
Conte S.; Choudhary P.; Iyer A.; Jansz P.; Macdonald P.; Muthiah K.
Institution
(Conte, Iyer, Jansz, Macdonald, Muthiah) St Vincent's Hospital Sydney,
Darlinghurst, NSW, Australia
(Conte, Iyer, Jansz, Macdonald, Muthiah) University of New South Wales,
Randwick, NSW, Australia
(Conte) University of Notre Dame Australia, Darlinghurst, NSW, Australia
(Choudhary) Westmead Private Hospital, Westmead, NSW, Australia
(Iyer, Jansz, Macdonald, Muthiah) Victor Chang Cardiac Research Institute,
Darlinghurst, NSW, Australia
Publisher
Elsevier Ltd
Abstract
Background: Protein-losing enteropathy (PLE), seen in up to 15% of
patients with Fontan circulation, results in hypoalbuminaemia and has
important nutritional, immunologic, and haemodynamic consequences.
Midodrine, an alpha-1-receptor agonist, increases lymphatic tone,
mitigating leak of lymph into the bowel. We present a patient with
advanced Fontan failure and PLE treated with midodrine, enabling
transplant candidacy. Case Presentation: Our patient had hypoplastic left
heart syndrome with Norwood procedure, bidirectional Glenn shunt, and
coarctation repair in infancy and Fontan completion (fenestrated) with
extra-cardiac conduit at age 6. At age 20, she developed increasing
oedema, orthopnoea, and decreased exercise tolerance. Comprehensive
investigations included low serum albumin, negative 24-hour urinary
albumin, and positive faecal alpha-1 antitrypsin. Right heart
catheterisation demonstrated elevated Fontan pressures of 24 mmHg and
echocardiography showed systemic right ventricular dilatation consistent
with concurrent PLE and a failing Fontan system. Her frailty and
malnourishment represented barriers to transplant. She was commenced on
midodrine 2.5 mg three times daily and over the ensuing 3 months, her
oedema improved resulting in greater exercise tolerance and better
engagement with physiotherapy. Due to ongoing New York Heart Association
class III symptoms, she was listed for heart transplantation. Her serum
albumin rose from a nadir of 16 g/L prior to midodrine to 33 g/L at
transplantation. <br/>Discussion(s): The improvements in her nutrition and
frailty enabled her candidacy and successful cardiac transplantation. We
performed a comprehensive Medline search, and this is first case
demonstrating the use of midodrine to bridge patients with PLE and ongoing
heart failure to successful heart transplantation.<br/>Copyright &#xa9;
2022

<59>
Accession Number
2019554332
Title
Aortic Valve Replacement Reduces Mortality in Moderate Aortic Stenosis: A
Systematic Review and Meta-Analysis.
Source
Heart Lung and Circulation. Conference: 70th Annual Scientific Meeting of
the Cardiac Society of Australia and New Zealand. Broadbeach Australia.
31(Supplement 3) (pp S247), 2022. Date of Publication: January 2022.
Author
Franke K.; Bhatia D.; Roberts-Thomson R.; Psaltis P.
Institution
(Franke, Bhatia, Psaltis) The University Of Adelaide, Adelaide, SA,
Australia
(Franke, Psaltis) South Australian Health and Medical Research Institute,
Adelaide, SA, Australia
(Franke, Roberts-Thomson, Psaltis) Royal Adelaide Hospital, Adelaide, SA,
Australia
Publisher
Elsevier Ltd
Abstract
Background: With the introduction of transcatheter aortic valve
replacement and an evolving understanding of the natural progression and
history of aortic stenosis, the potential for earlier intervention in
appropriate patients is promising; however, the benefit of aortic valve
replacement in moderate aortic stenosis remains unclear. <br/>Method(s):
PubMed, EMBASE, and the Cochrane Library databases were searched up until
30^th of December 2021 using keywords including moderate aortic
stenosis and aortic valve replacement. Studies reporting all-cause
mortality and outcomes in early AVR compared to conservative management in
patients with moderate AS were included. Hazard ratios were generated
using random-effects meta-analysis to determine effect estimates.
<br/>Result(s): 3,470 publications were screened with title and abstract
review, which left 169 articles for full-text review. Of these studies, 7
met inclusion criteria and were included, totalling 4,827 patients. All
studies treated AVR as a time-dependent co-variable in Cox-regression
multivariate analysis of all-cause mortality. Intervention with surgical
or transcatheter AVR was associated with a 45% decreased risk of all-cause
mortality (HR=0.55 [0.42-0.68], I²=51.5%, p<0.001). All studies
were representative of the overall cohort with appropriate sample sizes,
with no evidence of publication, detection, or information biases in all
studies. <br/>Conclusion(s): In this systematic review and meta-analysis,
we report a 45% reduction in all-cause mortality in patients with moderate
aortic stenosis who were treated with early aortic valve replacement
compared to a strategy of conservative management. Randomised control
trials are needed to determine the utility of AVR in moderate
AS.<br/>Copyright &#xa9; 2022

<60>
Accession Number
2019554318
Title
The Impact of Pre-Existing Atrial Fibrillation on Outcomes after
Percutaneous Mitral Valve Repair.
Source
Heart Lung and Circulation. Conference: 70th Annual Scientific Meeting of
the Cardiac Society of Australia and New Zealand. Broadbeach Australia.
31(Supplement 3) (pp S231-S232), 2022. Date of Publication: January 2022.
Author
Virk S.; Saxena A.; Henham P.; Jeremy R.; Bannon P.
Institution
(Virk) Department of Cardiology, Concord Repatriation General Hospital,
Sydney, Australia
(Saxena, Bannon) Department of Cardiothoracic Surgery, Royal Prince Alfred
Hospital, Sydney, Australia
(Henham) Western Health, Melbourne, Australia
(Jeremy, Bannon) Sydney Medical School, University of Sydney, Sydney,
Australia
(Bannon) Institute of Academic Surgery, The University of Sydney, Sydney,
Australia
Publisher
Elsevier Ltd
Abstract
Background: Atrial fibrillation is highly prevalent in patients with
mitral regurgitation, including those undergoing percutaneous mitral valve
repair (MVr). This meta-analysis aimed to quantify the prognostic impact
of pre-operative atrial fibrillation (preAF) on early and late clinical
outcomes after percutaneous MVr. <br/>Method(s): Medline, EMBASE and
CENTRAL databases were searched for studies reporting clinical outcomes
following percutaneous MVr according to the presence or absence of preAF.
Meta-analysis was performed using random-effects modelling for pre-defined
clinical endpoints. <br/>Result(s): Nine studies, including a total of
9,309 patients (5,468 with preAF), met eligibility criteria. PreAF was
associated with increased peri-procedural mortality (relative risk [RR]
1.35, 95% confidence interval [CI] 1.02-1.78, I²=0%, p=0.03)
and longer hospital stay (mean difference 0.65 days; 95% CI 0.36-0.93,
I²=0%, p<0.001). PreAF did not significantly increase risk of
peri-procedural stroke (RR 0.94, 95% CI 0.46-1.95), major bleeding (RR
0.91, 95% CI 0.18-4.61) or acute renal failure (RR 0.99, 95% CI
0.66-1.49). PreAF had no impact on procedural success (RR 1.00, 95% CI
0.99-1.01). At >=1-year follow-up, preAF was associated with increased
all-cause mortality (RR 1.40, 95% CI 1.22-1.60, I²=29%,
p<0.001), stroke (RR 1.61, 95% CI 1.08-2.40, I²=0%, p=0.02) and
heart failure hospitalisation (RR 1.14, 95% CI 1.02-1.28,
I²=0%, p=0.02), but not cardiovascular mortality (RR 1.15, 95%
CI 0.78-1.70). <br/>Conclusion(s): In patients undergoing percutaneous
MVr, preAF is a significant risk factor for peri-procedural and late
mortality, as well as increased incidence of stroke and heart failure
hospitalisation during follow-up.<br/>Copyright &#xa9; 2022

<61>
Accession Number
2019554315
Title
Feasibility of Selective Coronary Angiogram and Percutaneous Coronary
Intervention Following Self-Expanding Transcatheter Aortic Valve
Implantation - A Systematic Review and Meta-Analysis.
Source
Heart Lung and Circulation. Conference: 70th Annual Scientific Meeting of
the Cardiac Society of Australia and New Zealand. Broadbeach Australia.
31(Supplement 3) (pp S335), 2022. Date of Publication: January 2022.
Author
Gin J.; Vlachadis-Castles A.; Yudi M.
Institution
(Gin, Vlachadis-Castles, Yudi) Austin Health, Alphington, Vic, Australia
Publisher
Elsevier Ltd
Abstract
Background: Patients with severe aortic valve stenosis often have
concomitant coronary artery disease (CAD). Following transcatheter aortic
valve implantation (TAVI), patients may thus require coronary angiography
(CA) and percutaneous coronary intervention (PCI). However, in the
presence of a self-expanding TAVI device, coronary access may be a
concern. There is a paucity of studies that appraise the feasibility of CA
and PCI post TAVI. <br/>Method(s): We performed a systematic review and
meta-analysis of 15 studies to evaluate the feasibility of selective CAD
and PCI post TAVI with a self-expanding valve. <br/>Result(s): Selective
coronary angiographic study was feasible in 30% (95% CI 6.0-59,
I²=90.5%). Selective left CA was prevalent in 40% (95% CI
32-49, I²=66.3%) while selective right CA was 21% (95% CI
13-29, I²=73.2). Successful PCI was achieved 95% (95% CI
87-100, I²=47.5). <br/>Conclusion(s): This study highlights
that while selective CA is limited in patients with self-expanding TAVR,
PCI is feasible and largely successful.<br/>Copyright &#xa9; 2022

<62>
Accession Number
2019554298
Title
Does Down Syndrome Influence the Outcomes of Congenital Cardiac Surgery?.
Source
Heart Lung and Circulation. Conference: 70th Annual Scientific Meeting of
the Cardiac Society of Australia and New Zealand. Broadbeach Australia.
31(Supplement 3) (pp S268-S269), 2022. Date of Publication: January 2022.
Author
Wang B.; Verrocchi J.; Liew D.; Zentner D.
Institution
(Wang, Zentner) Department of Cardiology, The Royal Melbourne Hospital,
Parkville, VIC, Australia
(Verrocchi) Monash Health, Clayton, VIC, Australia
(Liew) Department of Epidemiology and Preventive Medicine, Monash
University, Clayton, VIC, Australia
(Zentner) Department of Medicine, University of Melbourne, Parkville, VIC,
Australia
Publisher
Elsevier Ltd
Abstract
Background: Congenital cardiac surgery for individuals with Down Syndrome
(DS) has historically occurred at reduced frequency. Little data is
available regarding long-term post congenital cardiac surgical outcomes.
Limited sample sizes and clinical heterogeneity require a pooled analysis
approach. Our aim was to assess whether post congenital cardiac surgery
outcome was influenced by DS diagnosis. <br/>Method(s): Databases
(Medline, EMBASE and PubMed) were searched utilising terms related to DS
and congenital heart disease. Studies that enrolled adults (>18 years)
with operated congenital heart disease and compared long term outcomes
with respect to DS presence were included. All study designs were
included, but those with limited/perioperative follow-up, non-English
texts, case studies and literature reviews excluded. Blinded screening,
data extraction and quality assessment were independently conducted by two
reviewers. QUIPS criteria were used for risk of bias analysis. Both random
and fixed effects models were used for meta-analysis. <br/>Result(s):
Twenty-three studies (n=10466) were included. Risk of bias was frequently
high due to unblinded retrospective study designs and analyses limited in
adjustment for other prognostic factors. Meta-analysis demonstrated no
effect of DS on long-term mortality (HR 0.86, 95% CI 0.6-1.23), to a
maximum described follow-up of 38 years. Lower cardiac reoperation risk
(HR 0.6, 95% CI 0.46-0.78) for individuals with DS was found on pooled
analysis. Meta-analysis was limited by between-study variation.
<br/>Conclusion(s): DS does not affect post congenital cardiac surgical
survival in adulthood. Reduced reoperation may reflect challenges in
assessing functional and symptomatic status and/or concerns regarding
perceived reoperation difficulties or likely benefits.<br/>Copyright
&#xa9; 2022

<63>
Accession Number
2019553301
Title
Transcatheter Aortic Valve Replacement Versus Sutureless and Rapid
Deployment Surgical Aortic Valve Replacement: A Systematic Review and
Meta-Analysis.
Source
Heart Lung and Circulation. Conference: 70th Annual Scientific Meeting of
the Cardiac Society of Australia and New Zealand. Broadbeach Australia.
31(Supplement 3) (pp S234-S235), 2022. Date of Publication: January 2022.
Author
Vlachadis Castles A.; Koshy A.; Raman J.; van Gaal W.; Yudi M.
Institution
(Vlachadis Castles, van Gaal) Northern Health, Epping, Vic, Australia
(Vlachadis Castles, Koshy, Raman, Yudi) Austin Hospital, Heidelberg, Vic,
Australia
(Vlachadis Castles, Koshy, Raman, van Gaal) University of Melbourne,
Parkville, Vic, Australia
(Raman) St Vincent's Hospital Melbourne, Fitzroy, Vic, Australia
(Raman) Deakin University, Geelong & Melbourne, Vic, Australia
(Raman) James Cook University, Townsville & Cairns, Qld, Australia
(Raman) University of Illinois, Urbana-Champaign, IL, United States
Publisher
Elsevier Ltd
Abstract
Background: Transcatheter aortic valve replacement (TAVR) and sutureless
and rapid deployment (SURD) valves are alternatives to traditional
surgical aortic valve replacement (AVR). However, there is a paucity of
data comparing these newer techniques. We performed a systematic review
and meta-analysis comparing clinical outcomes between TAVR and SURD
valves. <br/>Method(s): Searches of electronic databases were undertaken
to identify articles comparing clinical outcomes between TAVR and SURD
AVR. The primary endpoints were early mortality and mortality at longest
follow-up, stroke and myocardial infarction. Secondary endpoints were rate
of acute kidney injury, at least moderate paravalvular regurgitation (PVR)
and permanent pacemaker (PPM) implantation. Calculated summary estimates
are presented as odds ratio (OR) with 95% confidence intervals (CI).
<br/>Result(s): Twelve observational studies including 5,746 patients
(2,834 TAVR; 2,912 SURD) were included in this study. There was no
significant difference between TAVR and SURD AVR for early mortality (OR
1.77, p=0.14) or mortality at longest follow-up (OR 1.60, p=0.09), nor any
difference in post-operative stroke, acute kidney injury or myocardial
infarction (p=N/S). There was a higher rate of at least moderate PVR (OR
5.18, p=0.00) and PPM implantation (OR 1.50, p=0.03) in the TAVR cohort.
<br/>Conclusion(s): In this meta-analysis, there were no significant
differences in mortality or major cardiovascular events between the TAVR
and SURD AVR cohorts. However, rates of PVR and PPM implantation were
higher following TAVR. [Formula presented]<br/>Copyright &#xa9; 2022

<64>
Accession Number
2018412269
Title
Effectiveness of Active Chest Tube Clearance Versus Conventional Chest
Tube in Reducing Postoperative Complications After Cardiac Surgery: a
Systematic Review and Meta-analysis.
Source
SN Comprehensive Clinical Medicine. 4(1) (no pagination), 2022. Article
Number: 177. Date of Publication: December 2022.
Author
Hasan M.T.; Hagrass A.I.; Elkhrashy M.N.; Hamouda M.; shada N.M.; Hashem
S.M.; Al-kafarna M.; Almadhoon H.W.; Ragab K.M.; Nourelden A.Z.; Elsnhory
A.B.
Institution
(Hasan, Hagrass, Elkhrashy, Hamouda, Nourelden, Elsnhory) Faculty of
Medicine for Boys, Al-Azhar University, Cairo, Egypt
(Hasan, Hagrass, Elkhrashy, Hamouda, shada, Hashem, Al-kafarna, Almadhoon,
Ragab, Nourelden, Elsnhory) International Medical Research Association
(IMedRA), Cairo, Egypt
(Hagrass) Gamal Abdel Nasser Axis, The 3rd Settlement, New Cairo, Egypt
(shada, Hashem) Faculty of Medicine for Girls, Al-Azhar University, Cairo,
Egypt
(Al-kafarna) Faculty of Pharmacy, Al-Azhar University, Gaza, Palestine
(Almadhoon) Faculty of Dentistry, Al-Azhar University, Gaza, Palestine
(Ragab) Faculty of Medicine, Minia University, Minia, Egypt
Publisher
Springer Nature
Abstract
After heart surgery, the chest tube removes lost mediastinal blood.
Clogging of the chest tube may induce inadequate evacuation of fluids
surrounding the lungs and heart, leading to deadly consequences. This
meta-analysis compared the effectiveness of active chest tube clearance
(ATC) with conventional chest tube (CT) in lowering the incidence of
retained blood complications after heart surgery. We conducted a
systematic search of the available databases to identify cohort studies or
clinical trials that met our inclusion criteria. Studies that compared
active tube clearance and conventional tube in cardiac surgery were
included. The fixed or random-effects model was used to determine the
pooled effect estimates upon the heterogeneity of collected data. This
review included 7003 people from five cohort studies and three clinical
trials. As regard to retained blood, there was no significant difference
between chest tube types in matched group (RR = 0.67, 95% CI = [0.44,
1.04], P = 0.08) or unmatched group (RR = 0.64, 95% CI = [0.39, 1.04], P =
0.07). Re-exploration favored ATC in the matched group (RR = 0.64, 95% CI
= [0.43, 0.95], P = 0.03). The incidence of postoperative atrial
fibrillation was significantly lower in ATC in both matched (RR = 0.73,
95% CI = [0.61, 0.87], P = 0.0005) and unmatched groups (RR = 0.72, 95% CI
= [0.61, 0.84], P = 0.0005). This meta-analysis provides evidence on the
positive effect of active maintenance of chest tube patency during the
first hours of cardiac surgery, which resulted in reducing the incidence
of complications.<br/>Copyright &#xa9; 2022, The Author(s), under
exclusive licence to Springer Nature Switzerland AG.

<65>
Accession Number
2019595085
Title
Telehealth education improves parental care ability and postoperative
nutritional status of infants after CHD surgery: A prospective randomized
controlled study.
Source
Paediatrics and Child Health (Canada). 27(3) (pp 154-159), 2022. Date of
Publication: 01 Jun 2022.
Author
Zhang Q.-L.; Lei Y.-Q.; Liu J.-F.; Chen Q.; Cao H.
Institution
(Zhang, Lei, Liu, Chen, Cao) Department of Cardiac Surgery, Fujian
Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical
University, Fuzhou, China
(Zhang, Lei, Liu, Chen, Cao) Fujian Branch of Shanghai Children's Medical
Center, Fuzhou, China
(Zhang, Lei, Liu, Chen, Cao) Fujian Children's Hospital, Fuzhou, China
(Zhang, Lei, Liu, Chen, Cao) Fujian Key Laboratory of Women and Children's
Critical Diseases Research, Fujian Maternity and Child Health Hospital,
Fuzhou, China
Publisher
Oxford University Press
Abstract
Objective: This study aimed to explore the effect of telehealth education
on improving the parental care ability and postoperative nutritional
status of infants after congenital heart disease surgery. <br/>Method(s):
A prospective randomized controlled study was conducted at a provincial
maternal and child hospital in southeastern China. A total of 84 infants
were enrolled in the study, with 42 infants in the intervention group and
42 infants in the control group. <br/>Result(s): Body weight, albumin,
prealbumin, and hemoglobin of infants in the intervention group were
significantly higher than those in the control group one month after
discharge (P<0.05). The STRONGkids score of infants in the intervention
group was significantly higher than that of those in the control group one
month after discharge (P<0.05). The Family Caregiver Task Inventory score
of infants in the intervention group was significantly lower than that of
those in the control group one month after discharge (P<0.05).
<br/>Conclusion(s): Performing telehealth education about home feeding and
care guidance for parents of infants after congenital heart disease
surgery can greatly improve parental care ability so that infants get
better feeding and care, which can effectively improve the postoperative
nutritional status of the infants. <br/>Copyright &#xa9; 2022 The
Author(s). Published by Oxford University Press on behalf of the Canadian
Paediatric Society. All rights reserved.

<66>
[Use Link to view the full text]
Accession Number
2019580964
Title
Association between obstructive sleep apnea (OSA) and atrial fibrillation
(AF): A dose-response meta-analysis.
Source
Medicine (United States). 101(30) (pp E29443), 2022. Date of Publication:
29 Jul 2022.
Author
Zhang D.; Ma Y.; Xu J.; Yi F.
Institution
(Zhang, Ma, Xu, Yi) Department of Cardiology, Xijing Hospital, The Air
Force Military Medical University, Shaanxi, Xi'an 710032, China
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Refractory hypoxemia episodes are characteristic of
obstructive sleep apnea (OSA). Patients with OSA suffer from oxidative
stress in all systems. Atrial fibrillation (AF) is a type of arrhythmia
that may be induced by OSA. In this study, we explored the dose-response
relationship between OSA and AF. Our research provides the basis for a
novel approach to AF prevention. <br/>Method(s): We screened four
databases (PubMed, Embase, the Cochrane Library, and Web of Science) for
observational studies on OSA and AF. Studies were collected from database
establishment to November 2020. We performed a traditional subgroup
meta-analysis. Linear and spline dose-response models were applied to
assess the association between the apnea-hypopnea index, an indicator of
OSA severity, and the risk of AF. Review Manager version 5.3 software and
Stata 16.0 were used for the analysis. <br/>Result(s): Sixteen
observational studies were included in the study. We excluded a study from
the conventional meta-analysis. In the subgroup analysis, the odds ratios
for new onset AF for no obvious reason, new onset AF after surgical
operations, such as coronary artery bypass grafting, and AF after ablation
treatment were 1.71 (95% CI 1.37-2.13, P <.05), 2.65 (95% CI 2.32-3.01, P
<.05), and 2.93 (95% CI 2.47-3.49, P <.05), respectively. Linear
dose-response meta-analysis results revealed that the risk of AF increased
with increasing apnea-hypopnea index value. <br/>Conclusion(s): Through
dose-response meta-analysis, we found a potential dose-response
relationship between OSA severity and the risk of AF. This relationship
should be considered in interventions aimed at AF prevention in the
future.<br/>Copyright &#xa9; 2022 Lippincott Williams and Wilkins. All
rights reserved.

<67>
Accession Number
2018431506
Title
Prognostic value of cardiac magnetic resonance derived global longitudinal
strain analysis in patients with ischaemic and non-ischaemic dilated
cardiomyopathy: a systematic review and meta-analysis.
Source
International Journal of Cardiovascular Imaging. (no pagination), 2022.
Date of Publication: 2022.
Author
Fong L.C.W.; Lee N.H.C.; Poon J.W.L.; Chin C.W.L.; He B.; Luo L.; Chen C.;
Wan E.Y.F.; Pennell D.J.; Mohiaddin R.; Ng M.-Y.
Institution
(Fong, Lee, Ng) Department of Diagnostic Radiology, School of Clinical
Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong,
Queen Mary Hospital Hong Kong, Hong Kong
(Poon) Department of Medicine, Ruttonjee and Tang Shiu Kin Hospitals, Hong
Kong
(Chin) Department of Cardiology, National Heart Centre Singapore,
Singapore, Singapore
(He, Luo, Chen, Ng) Department of Medical Imaging, The University of Hong
Kong-Shenzhen Hospital, Shenzhen, China
(Wan) Department of Family Medicine and Primary Care, Li Ka Shing Faculty
of Medicine, The University of Hong Kong, Hong Kong
(Pennell, Mohiaddin) Royal Brompton Hospital, Guy's and St Thomas' NHS
Foundation Trust, London, United Kingdom
(Pennell, Mohiaddin) Imperial College, London, United Kingdom
(Wan) Centre for Safe Medication Practice and Research, Department of
Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University
of Hong Kong, Hong Kong
(Wan) Laboratory of Data Discovery for Health (D24H), Hong Kong
(Chin) Cardiovascular ACP, Duke-NUS Medical School, Singapore, Singapore
Publisher
Springer Science and Business Media B.V.
Abstract
Cardiac magnetic resonance (CMR) derived left ventricular global
longitudinal strain (LV-GLS) for evaluating dilated cardiomyopathy
patients has been addressed in studies with contradictory results. We
therefore performed the first systematic review evaluating evidence on the
prognostic value of CMR derived LV-GLS for ischaemic (IDCM) and
non-ischaemic dilated cardiomyopathy (NDCM) patients. Systematic review
(PROSPERO CRD42020171582) identified studies up to January 2021 that
measured LV-GLS for predicting major adverse cardiac events among dilated
cardiomyopathy patients. Studies were identified from MEDLINE, Embase and
PubMed by two independent reviewers. 2099 studies were screened. Three
prospective and three retrospective observational studies comprising of
1758 patients (29% IDCM patients; 71% NDCM patients) with a weighted mean
follow up of 3 years (SD = 1 year) were identified. All six studies
included mortality in the primary composite outcome. LV-GLS was associated
with increase primary composite outcome among mild to moderately impaired
left ventricular ejection fraction (LVEF) IDCM and NDCM patients (> 30%)
in univariable and multivariable analysis. Association was lost among
severely impaired LVEF patients (< 30%). From sensitivity analysis, LV-GLS
showed significant association with death among NDCM patients (HR 1.27;
95% CI 1.10-1.46; p = 0.001; I² = 59%) but insignificant for
heart transplant outcome (HR 1.23; 95% CI 0.46-3.33; p = 0.68,
I² = 44%). LV-GLS threshold for effectively stratifying
patients is - 12.5% to - 13.5%. LVEF in IDCM and NDCM became an
insignificant prognostic marker in multivariable analysis. CMR LV-GLS
shows promise as an independent predictor of mortality in IDCM and NDCM
patients. However, in patients with LVEF < 30% LV-GLS may have less
prognostic value. Prospero Registration: CRD42020171582.<br/>Copyright
&#xa9; 2022, The Author(s), under exclusive licence to Springer Nature
B.V.

<68>
Accession Number
2018385586
Title
FDG PET/CT in Cardiac Infection: Does It Matter? A Narrative Review.
Source
Infectious Diseases and Therapy. (no pagination), 2022. Date of
Publication: 2022.
Author
Ghanem-Zoubi N.
Institution
(Ghanem-Zoubi) Infectious Diseases Institute, Rambam Health Care Campus,
Ha-Aliya 8 St, Haifa 3109601, Israel
(Ghanem-Zoubi) The Ruth and Bruce Rappaport Faculty of Medicine, Technion,
Israel Institute of Technology, Haifa, Israel
Publisher
Adis
Abstract
The limited performance of echocardiography in specific infectious
processes involving the heart led to the search for additional diagnostic
tools. Fluorodeoxyglucose positron emission tomography computed tomography
(FDG PET/CT) has been proposed for its diagnostic abilities in several
infectious diseases including cardiac infections. A literature review of
studies evaluating FDG PET/CT in native valve infective endocarditis (IE),
prosthetic valve IE, cardiac implantable electrical device (CIED)
infection, and left ventricular assist device (LVAD) infection is
presented, focusing on studies published in recent years. Overall, in
prosthetic valve endocarditis (PVE), FDG PET/CT demonstrate high
sensitivity (73-93%) and specificity (80-95%), while in native valve
endocarditis (NVE) the sensitivity is very low (22-68%), with high
specificity (97-100%) similar to PVE. For CIED, LVAD infection, and
transcatheter aortic valve implantation associated endocarditis, data come
from small studies and show good diagnostic performance of FDG PET/CT.
International guidelines are increasingly recommending FDG PET/CT for the
diagnosis of specific conditions of cardiac infections. Beyond the
diagnostic performance ability, few studies have evaluated the added
benefit of FDG PET/CT in terms of clinical outcomes of patients with
suspected cardiac infection. This should be the focus in future
studies.<br/>Copyright &#xa9; 2022, The Author(s).

<69>
Accession Number
2018375080
Title
Comparing health outcomes between coronary interventions in frail patients
aged 75 years or older with acute coronary syndrome: a systematic review.
Source
European Geriatric Medicine. (no pagination), 2022. Date of Publication:
2022.
Author
van Wyk G.W.; Berkovsky S.; Fraile Navarro D.; Coiera E.
Institution
(van Wyk, Berkovsky, Fraile Navarro, Coiera) Australian Institute of
Health Innovation, Faculty of Medicine, Health and Human Sciences,
Macquarie University, 75 Talavera Rd, Macquarie Park, NSW 2113, Australia
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Purpose: To assess current evidence comparing the impact of available
coronary interventions in frail patients aged 75 years or older with
different subtypes of acute coronary syndrome (ACS) on health outcomes.
<br/>Method(s): Scopus, Embase and PubMed were systematically searched in
May 2022 for studies comparing outcomes between coronary interventions in
frail older patients with ACS. Studies were excluded if they provided no
objective assessment of frailty during the index admission,
under-represented patients aged 75 years or older, or included patients
with non-ACS coronary disease without presenting results for the ACS
subgroup. Following data extraction from the included studies, a
qualitative synthesis of results was undertaken. <br/>Result(s): Nine
studies met all eligibility criteria. All eligible studies were
observational. Substantial heterogeneity was observed across study designs
regarding ACS subtypes included, frailty assessments used, coronary
interventions compared, and outcomes studied. All studies were assessed to
be at high risk of bias. Notably, adjustment for confounders was limited
or not adequately reported in all studies. The comparative assessment
suggested a possible efficacy signal for invasive treatment relative to
conservative treatment but possibly at the risk of increased bleeding
events. <br/>Conclusion(s): There is a paucity of evidence comparing
health outcomes between different coronary interventions in frail patients
aged 75 years or older with ACS. Available evidence is at high risk of
bias. Given the growing importance of ACS in frail patients aged 75 years
or older, new studies are needed to inform optimal ACS care for this
population. Future studies should rigorously adjust for confounders.

<70>
Accession Number
2019459747
Title
Interpectoral-pectoserratus plane (PECS II) block in patients undergoing
trans-axillary thoracic outlet decompression surgery; A prospective
double-blind, randomized, placebo-controlled clinical trial.
Source
Journal of Clinical Anesthesia. 82 (no pagination), 2022. Article Number:
110939. Date of Publication: November 2022.
Author
van den Broek R.J.C.; Goeteyn J.; Houterman S.; Bouwman R.A.; Versyck
B.J.B.; Teijink J.A.W.
Institution
(van den Broek, Bouwman, Versyck) Department of Anesthesiology and Pain
medicine, Catharina hospital, Michelangelolaan 2, Eindhoven 5623 EJ,
Netherlands
(van den Broek, Goeteyn, Teijink) Faculty of Health, Medicine and Life
Sciences, Department of Epidemiology, CAPHRI School for Public Health and
Primary Care, Maastricht University, Universiteitssingel 40, Maastricht
6229 ER, Netherlands
(Goeteyn, Teijink) Department of Vascular Surgery, Catharina hospital,
Michelangelolaan 2, Eindhoven 5623 EJ, Netherlands
(Houterman) Department of Education and Research, Catharina Hospital,
Michelangelolaan 2, Eindhoven 5623 EJ, Netherlands
(Bouwman) Department of Electrical Engineering, Eindhoven University of
Technology, Groene Loper 19, Eindhoven 5612 AP, Netherlands
(Versyck) Department of Anesthesiology and Pain Medicine, AZ Turnhout,
Steenweg op Merksplas 44, Turnhout 2300, Belgium
Publisher
Elsevier Inc.
Abstract
Study objective: To investigate if an interpectoral-pectoserratus plane
(PECS II) block decreases postoperative pain, postoperative nausea and
vomiting and improves quality of recovery in patients with neurogenic
thoracic outlet syndrome (NTOS) undergoing trans-axillary thoracic outlet
decompression surgery. <br/>Design(s): A prospective single center double
blinded randomized placebo-controlled trial. <br/>Setting(s):
Perioperative period; operating room, post anesthesia care unit (PACU) and
hospital ward. <br/>Patient(s): Seventy patients with NTOS, undergoing
trans-axillary thoracic outlet decompression surgery.
<br/>Intervention(s): Patients were randomized to an interventional arm,
receiving the block with 40 ml ropivacaine 0.5% (concentration was
adjusted if the patient's weight was <66 kg), and a placebo group,
receiving a sham block with 40 ml NaCl 0.9%. The
interpectoral-pectoserratus plane block was performed ultrasound guided;
the first injection below the pectoral minor muscle and the second below
the pectoral major muscle. The hospitals' pharmacist prepared the study
medication and was the only person able to see the randomization result.
The study was blinded for patients, researchers and medical personnel.
Measurements: Primary outcome parameters were postoperative pain, measured
by numeric rating scale on the PACU (start and end) and on the ward on
postoperative day (POD) 0 and 1, and postoperative morphine consumption,
measured on the PACU and on the ward during the first 24 h. Secondary
outcome parameters were postoperative nausea and vomiting, and quality of
recovery. <br/>Main Result(s): There was no statistically significant
difference in NRS on the PACU at the start (ropivacaine 4.9 +/- 3.2 vs
placebo 6.2 +/- 3.0, p = .07), at the end (ropivacaine 4.0 +/- 1.7 vs
placebo 3.9 +/- 1.7, p = .77), on the ward on POD 0 (ropivacaine 4.6 +/-
2.0 vs placebo 4.6 +/- 2.0, p = 1.00) or POD 1 (ropivacaine 3.9 +/- 1.8 vs
placebo 3.6 +/- 2.0, p = .53). There was no difference in postoperative
morphine consumption at the PACU (ropivacaine 11.0 mg +/- 6.5 vs placebo
10.8 mg +/- 4.8, p = .91) or on the ward (ropivacaine 11.6 mg +/- 8.5 vs
placebo 9.6 mg +/- 9.4, p = .39). <br/>Conclusion(s): The
interpectoral-pectoserratus plane block is not effective for postoperative
analgesia in patients with NTOS undergoing trans-axillary thoracic outlet
decompression surgery.<br/>Copyright &#xa9; 2022 Elsevier Inc.

<71>
Accession Number
2019196161
Title
Omega-3 Polyunsaturated Fatty Acids: the Role in Prevention of Atrial
Fibrillation in Patients with Coronary Artery Disease after Coronary
Artery Bypass Graft Surgery.
Source
Rational Pharmacotherapy in Cardiology. 18(1) (pp 12-19), 2022. Date of
Publication: 2022.
Author
Rubanenko O.A.; Shchukin Yu.V.; Limareva L.V.; Ryazanova T.K.; Rubanenko
A.O.; Davydkin I.L.
Institution
(Rubanenko, Shchukin, Limareva, Ryazanova, Rubanenko, Davydkin) Samara
State Medical University, Samara, Russian Federation
Publisher
Stolichnaya Izdatelskaya Kompaniya
Abstract
Aim. To estimate the role of omega-3 polyunsaturated fatty acids (PUFAs)
administration in atrial fibrillation (AF) prevention after planned
coronary artery bypass graft (CABG) surgery. Material and Methods. Studied
were 306 patients divided into two groups: patients of group I didn't
receive PUFAs (158 patients, 82.7% males) and patients of group II
received PUFAs (148 patients, 89.3% males). PUFAs were prescribed in daily
dose 2000 mg 5 days before surgery and in daily dose 1000 mg in
postoperative period during 21 days. Results. Postoperative AF (POAF)
occurred in 29.7% patients in group I and in 16.9% patients in group II
(p=0.009). We found that after CABG in patients of the I group median IL-6
level was 39.3% higher (p=0.001), interleukin-10 - 20.2% higher (p=0.01),
superoxide dismutase - 78.9% higher (p<0.001), malondialdehyde - 33.8%
higher (p=0.03), docosahexaenoic acid - 31.8% lower (p=0.01) and omega-3
index - 43.4% lower (p=0.04) than in patients of the II group. According
to multivariate regression analysis we found significant association
between the factors of inflammation, oxidative stress and the risk POAF
development. Conclusions. In patients who took PUFAs, we found less
activation of inflammation, oxidative stress, the increasing of
docosahexaenoic acid and omega-3 index accompanied by the decreasing of
POAF development rates up to 12.8%.<br/>Copyright &#xa9; 2022 Stolichnaya
Izdatelskaya Kompaniya. All rights reserved.

<72>
Accession Number
2018264887
Title
Early and midterm outcomes of transcatheter aortic-valve replacement with
balloon-expandable versus self-expanding valves: A meta-analysis.
Source
Journal of Cardiology. 80(3) (pp 204-210), 2022. Date of Publication:
September 2022.
Author
Zhang X.-L.; Wei Z.-H.; Wang H.-W.; Xu W.; Wang Y.; Xu B.
Institution
(Zhang, Wei, Xu, Xu) Department of Cardiology, Affiliated Drum Tower
Hospital, Nanjing University School of Medicine, Nanjing, China
(Wang, Wang) State Key Laboratory of Chemistry for Life Science, Jiangsu
Key Laboratory of Molecular Medicine, Medical School, Nanjing University,
Nanjing, China
Publisher
Japanese College of Cardiology (Nippon-Sinzobyo-Gakkai)
Abstract
Background: Current guidelines provide recommendation for transcatheter
aortic-valve replacement (TAVR) in severe aortic stenosis without emphasis
on valve systems. The comparative performances of balloon-expandable
valves (BEV) and self-expanding valves (SEV) remain unclear. We aim to
compare the early (30-day) and midterm (1-year) mortality and
cardiovascular outcomes of BEV with SEV. <br/>Method(s): PubMed, CENTRAL,
and EMBASE were searched from inception to February 13, 2020 for
randomized controlled trials (RCTs) and propensity-score matched (PSM)
studies. Odds ratios (ORs) for binary outcomes and mean differences for
continuous outcomes were pooled using random-effect models
(DerSimonian-Laird method) with Hartung-Knapp-Sidik-Jonkman variance
correction. Primary outcomes were early and midterm all-cause mortality.
<br/>Result(s): We included 3 RCTs (1418 patients) and 12 PSM studies
(36,540 patients). Compared with SEV, BEV was associated with
significantly lower mortality at 30 days (OR 0.76, 95% CI 0.67-0.85, p <
0.001, I2 = 0) and 1 year (OR 0.87, 95% CI 0.77-0.99, p = 0.04, I2 =
20.4%) in PSM studies, but not RCTs with insufficient power. Similar
findings were found in subgroups analysis based on valve generations and
SEV types. The 30-day and 1-year cardiovascular mortality, 30-day
incidences of moderate to severe paravalvular leak, procedural contrast
agent volume, and procedure time were lower, but transvalvular pressure
gradient was higher in BEV than SEV in PSM studies. The 30-day incidences
of permanent pacemaker implantation (PPI), acute kidney injury, stroke,
major bleeding, major vascular complications, and rehospitalization were
not statistically different between BEV and SEV. Early-generation SEV was
associated with a higher 30-day PPI risk than corresponding BEV
comparators. PPI risk was lower in ACURATE neo (Boston Scientific, Natick,
MA) but higher in Evolut R SEV (Medtronic Inc., Minneapolis, MN), both
compared with SAPIEN 3 BEV (Edwards Lifesciences, Irvine, CA).
<br/>Conclusion(s): PSM studies suggest lower early and midterm mortality
in BEV than SEV, but the contribution of unmeasured confounders cannot be
excluded. Results from adequately powered RCTs with long-term follow-up
are critically needed to confirm these findings.<br/>Copyright &#xa9; 2022
Elsevier Ltd

<73>
Accession Number
2017753146
Title
Metabolic Associated Fatty Liver Disease Increases the Risk of Systemic
Complications and Mortality. A Meta-Analysis and Systematic Review of 12
620 736 Individuals.
Source
Endocrine Practice. 28(7) (pp 667-672), 2022. Date of Publication: July
2022.
Author
Quek J.; Ng C.H.; Tang A.S.P.; Chew N.; Chan M.; Khoo C.M.; Wei C.P.; Chin
Y.H.; Tay P.; Lim G.; Tan D.J.H.; Lim W.H.; Chan K.E.; Teng M.; Tan E.;
Tamaki N.; Huang D.Q.; Siddiqui M.S.; Young D.Y.; Noureddin M.; Muthiah
M.D.
Institution
(Quek, Ng, Tang, Chew, Chan, Wei, Chin, Tay, Tan, Lim, Chan, Teng, Tan,
Huang, Young) Yong Loo Lin School of Medicine, National University of
Singapore, Singapore
(Chew, Chan) Department of Cardiology, National University Heart Centre,
National University Hospital, Singapore
(Khoo) Division of Endocrinology, Department of Medicine, National
University Hospital, Singapore
(Lim, Teng, Tan, Huang, Young, Muthiah) Division of Gastroenterology and
Hepatology, Department of Medicine, National University Hospital,
Singapore
(Tan, Huang, Muthiah) National University Centre for Organ
Transplantation, National University Health System, Singapore
(Tamaki) NAFLD Research Center, Division of Medicine, University of
California San Diego, La Jolla, California
(Tamaki) Department of Gastroenterology and Hepatology, Musashino Red
Cross Hospital, Tokyo, Japan
(Siddiqui) Division of Gastroenterology, Hepatology, and Nutrition,
Department of Internal Medicine, Virginia Commonwealth University,
Virginia
(Noureddin) Cedars-Sinai Fatty Liver Program, Division of Digestive and
Liver Diseases, Department of Medicine, Comprehensive Transplant Center,
Cedars-Sinai Medical Centre, Los Angeles, California
Publisher
Elsevier B.V.
Abstract
Objective: The recent introduction of the term metabolic associated fatty
liver disease (MAFLD) sought to reclassify nonalcoholic fatty liver
disease (NAFLD). MAFLD is thought to improve the encapsulation of
metabolic dysregulation. However, recent evidence has found significant
differences between MAFLD and NAFLD, and prevailing knowledge has largely
arisen from studies on NAFLD. Hence, we conducted a meta-analysis and
systematic review of the outcomes associated with MAFLD. <br/>Method(s):
MEDLINE and Embase databases were searched for articles relating to
outcomes in MAFLD. Analysis was conducted in random effects with hazard
ratios (HRs) to account for longitudinal risk assessment of mortality and
systemic complications. <br/>Result(s): A total of 554 articles were
identified, of which 17 articles were included. MAFLD resulted in an
increase in the overall mortality (HR, 1.24; confidence interval [CI],
1.13-1.34), cancer-related mortality (HR, 1.27; CI, 1.01-1.54), and
cardiovascular disease mortality (HR, 1.28, 1.03-1.53; P =.04) compared
with non-MAFLD. MAFLD also increases the risk of cardiovascular events
(HR, 1.49; CI, 1.34-1.64; P <.01), stroke (HR, 1.55; CI, 1.37-1.73; P
<.01), and chronic kidney disease (HR, 1.53; CI, 1.38-1.68). The presence
of MAFLD was also associated with an increased risk of heart failure,
obstructive sleep apnea, and malignancy. <br/>Conclusion(s): MAFLD can
significantly elevate the risk of systemic diseases and mortality. The
care of MAFLD thus requires interdisciplinary collaboration, and future
clinical trials conducted on MAFLD should aim to reduce the incidence of
end-organ damage aside from improving liver histology.<br/>Copyright
&#xa9; 2022 AACE

<74>
Accession Number
2017537888
Title
Iron homeostasis in heart transplant recipients randomized to ferric
derisomaltose or placebo.
Source
Clinical Transplantation. 36(7) (no pagination), 2022. Article Number:
e14695. Date of Publication: July 2022.
Author
Brautaset Englund K.V.; Ostby C.M.; Broch K.; Ueland T.; Aukrust P.; Gude
E.; Andreassen A.K.; Gullestad L.
Institution
(Brautaset Englund, Broch, Aukrust, Gullestad) Institute of Clinical
Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
(Brautaset Englund, Ostby, Broch, Gude, Andreassen, Gullestad) Department
of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
(Brautaset Englund, Broch, Gude, Andreassen, Gullestad) K.G. Jebsen
Cardiac Research Center and Center for Heart Failure Research, Faculty of
Medicine, University of Oslo, Oslo, Norway
(Ueland, Aukrust) Research Institute of Internal Medicine, Oslo University
Hospital Rikshospitalet, Oslo, Norway
(Aukrust) Department of Rheumatology, Dermatology and Infectious Disease,
Oslo University Hospital, Oslo, Norway
Publisher
John Wiley and Sons Inc
Abstract
Introduction: The randomized IronIC trial evaluated the effect of
intravenous ferric derisomaltose on physical capacity in iron-deficient,
maintenance heart transplant (HTx) recipients. Iron deficiency was defined
as in heart failure with high cut-points for ferritin to compensate for
inflammation. However, intravenous iron did not improve physical capacity
except in patients with ferritin <30 mug/L. We aimed to explore
determinants of iron status in the 102 IronIC participants to better
define iron deficiency in the HTx population. <br/>Method(s): We assessed
key governors of iron homeostasis, such as hepcidin, soluble transferrin
receptor (sTfR), and interleukin-6 (IL-6). We also measured growth factors
and inflammatory markers with relevance for iron metabolism. The results
were compared to those of 21 healthy controls. <br/>Result(s): Hepcidin
did not differ between HTx recipients and controls, even though markers of
inflammation were modestly elevated. However, HTx recipients with ferritin
<30 mug/L or sTfR above the reference range had significantly reduced
hepcidin levels suggestive of true iron deficiency. In these patients,
intravenous iron improved peak oxygen uptake. Hepcidin correlated
positively with ferritin and negatively with sTfR. <br/>Conclusion(s): HTx
recipients with iron deficiency as defined in heart failure do not have
elevated hepcidin levels, although inflammatory markers are modestly
increased. The high ferritin cut-offs used in heart failure may not be
suitable to define iron deficiency in the HTx population. We suggest that
hepcidin and sTfR should be measured to identify patients with true iron
deficiency, who might benefit from treatment with intravenous
iron.<br/>Copyright &#xa9; 2022 John Wiley & Sons A/S. Published by John
Wiley & Sons Ltd.

<75>
Accession Number
2016880455
Title
Angiotensin-converting enzyme inhibitor therapy after heart transplant:
From molecular basis to clinical effects.
Source
Clinical Transplantation. 36(7) (no pagination), 2022. Article Number:
e14696. Date of Publication: July 2022.
Author
Masarone D.; Tedford R.J.; Melillo E.; Petraio A.; Pacileo G.
Institution
(Masarone, Melillo, Pacileo) Heart Failure Unit, Department of Cardiology,
AORN dei Colli-Monaldi Hospital, Naples, Italy
(Tedford) Division of Cardiology, Department of Medicine, Medical
University of South Carolina, Charleston, SC, United States
(Petraio) Heart Transplant Unit, Department of Cardiac Surgery and Heart
Transplant, AORN dei Colli-Monaldi Hospital, Naples, Italy
Publisher
John Wiley and Sons Inc
Abstract
The use of angiotensin-converting enzyme inhibitors is an important
therapy for various cardiovascular diseases, such as hypertension,
ischemic heart disease and heart failure (HF). In heart transplant
recipients, angiotensin-converting enzyme inhibitors have been
demonstrated to be a keystone for the treatment of hypertension with a
wide spectrum of pleiotropic molecular effects ranging from improvement of
the peripheral vascular system to regulation of the fluid and sodium
balance. In addition, angiotensin-converting enzyme inhibitors may be also
useful in the prevention of graft failure, cardiac allograft vasculopathy
(CAV) and chronic kidney disease (CKD) progression. Further tailored
multicenter and randomized studies are warranted to confirm the
pleiotropic clinical effects of ACEi therapy in HTRs and to support more
extended use in daily clinical practice. Finally in the near future, the
use of novel pharmacological agents that inhibit the
renin-angiotensin-aldosterone system (RAAS) such as the neprilysin
inhibitor sacubitril should be investigated in heart transplant
recipients.<br/>Copyright &#xa9; 2022 John Wiley & Sons A/S. Published by
John Wiley & Sons Ltd.

<76>
Accession Number
2014191635
Title
A prospective multicentre randomised all-comers trial to assess the safety
and effectiveness of the thin-strut sirolimus-eluting coronary stent
supraflex: Rationale and design of the thin strut sirolimus-eluting stent
in All Comers Population vs Everolimus-eluting Stent (TALENT) trial.
Source
EuroIntervention. 15(4) (pp E362-E369), 2019. Date of Publication: July
2019.
Author
Modolo R.; Chichareon P.; Kogame N.; Asano T.; Chang C.C.; de Winter R.J.;
Kaul U.; Zaman A.; Spitzer E.; Takahashi K.; Katagiri Y.; Soliman O.; van
Es G.A.; Morel M.-A.; Onuma Y.; Serruys P.W.
Institution
(Modolo, Chichareon, Kogame, Asano, de Winter, Takahashi, Katagiri)
Department of Cardiology, Academic Medical Center, University of
Amsterdam, Amsterdam, Netherlands
(Modolo) Department of Internal Medicine, Cardiology Division, University
of Campinas (UNICAMP), Campinas, Brazil
(Chichareon) Division of Cardiovascular Medicine, Department of Internal
Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla,
Hatyai, Thailand
(Chang, Spitzer, Soliman, Onuma) Thoraxcenter, Erasmus University Medical
Center, Rotterdam, Netherlands
(Kaul) Dean Academics and Research, Batra Hospital and Medical Research
Center, New Delhi, India
(Zaman) Freeman HospitalInstitute of Cellular Medicine, Newcastle
University, Newcastle upon Tyne, United Kingdom
(Spitzer, Soliman, van Es, Morel, Onuma) Cardialysis Clinical Trials
Management and Core Laboratories, Rotterdam, Netherlands
(Serruys) Imperial College London, London, United Kingdom
Publisher
Europa Group
Abstract
Aims: The aim of this study is to compare the SUPRAFLEX sirolimus-eluting
stent (SES) with the XIENCE everolimus-eluting stent (EES) with respect to
target lesion failure (TLF) at 12 months in a noninferiority trial in a
"real-world"patient population. <br/>Methods and Results: This is a
prospective, randomised, 1:1 balanced, controlled, single-blind,
multicentre study comparing clinical outcomes at 12 months between
SUPRAFLEX and XIENCE in an "allcomers"patient population, comprising a
total of 1,430 enrolled subjects with symptomatic coronary artery disease
who qualify for percutaneous coronary interventions at 23 centres in
Europe. The primary endpoint is a non-inferiority comparison of the
device-oriented composite endpoint target lesion failure (cardiac death,
target vessel myocardial infarction and clinically indicated target lesion
revascularisation) of the SUPRAFLEX group to the XIENCE group at 12 months
post procedure. Secondary endpoints include the patient-oriented composite
endpoint, target vessel failure, mortality, myocardial infarction,
revascularisation and stent thrombosis rates (ARC classification).
<br/>Conclusion(s): The TALENT trial aims to assess the safety and
effectiveness of the thin-strut SUPRAFLEX compared to the current standard
of care (XIENCE EES) in patients with atherosclerotic lesions. This will
provide valuable information on the impact of this thin-strut device in an
all-comers population.<br/>Copyright &#xa9; Europa Digital & Publishing
2019.

<77>
Accession Number
637370221
Title
Efficacy and safety of proton pump inhibitors versus histamine-2 receptor
blockers in the cardiac surgical population: insights from the PEPTIC
trial.
Source
European journal of cardio-thoracic surgery : official journal of the
European Association for Cardio-thoracic Surgery. 62(2) (no pagination),
2022. Date of Publication: 11 Jul 2022.
Author
van Diepen S.; Coulson T.; Wang X.; Opgenorth D.; Zuege D.J.; Harris J.;
Agyemang M.; Niven D.J.; Bellomo R.; Wright S.E.; Young P.J.; Bagshaw S.M.
Institution
(van Diepen, Opgenorth, Bagshaw) Department of Critical Care Medicine,
University of Alberta, Alberta Health Services, Edmonton, AB, Canada
(van Diepen) Division of Cardiology, Department of Medicine, University of
Alberta, Edmonton, AB, Canada
(Coulson) Department of Anaesthesiology and Perioperative Medicine, Alfred
Hospital, Melbourne, VIC, Australia
(Coulson, Bellomo, Young) Australian and New Zealand Intensive Care
Research Centre, Department of Epidemiology and Preventive Medicine,
School of Public Health and Preventive Medicine, Monash University,
Melbourne, VIC, Australia
(Coulson, Bellomo, Young) Department of Critical Care, University of
Melbourne, Parkville, VIC, Australia
(Wang) Health Services Statistical and Analytic Methods, Alberta Health
Services, Calgary, AB, Canada
(Zuege, Niven) Department of Critical Care Medicine, University of
Calgary, Alberta Health Services, Calgary, AB, Canada
(Zuege, Bagshaw) Critical Care Strategic Clinical Network, Alberta Health
Services, Calgary, AB, Canada
(Harris) Alberta Health Services, Calgary, AB, Canada
(Agyemang, Niven) Department of Community Health Sciences, University of
Calgary, Calgary, AB, Canada
(Bellomo) Department of Intensive Care, Royal Melbourne Hospital,
Melbourne, VIC, Australia
(Bellomo) Data Analytics Research & Evaluation Centre, University of
Melbourne and Austin Hospital, Melbourne, VIC, Australia
(Wright) Intensive Care Unit, Freeman Hospital, Newcastle upon Tyne,
United Kingdom
(Young) Medical Research Institute of New Zealand, Wellington, New Zealand
(Young) Intensive Care Unit, Wellington Regional Hospital, Wellington, New
Zealand
Publisher
NLM (Medline)
Abstract
OBJECTIVES: The comparative effectiveness and safety of proton pump
inhibitors (PPIs) versus histamine-2 receptor blockers for stress ulcer
prophylaxis in the cardiac surgical intensive care unit population is
uncertain. Although the Proton Pump Inhibitors versus Histamine-2 Receptor
Blockers for Ulcer Prophylaxis Therapy in the Intensive Care Unit (PEPTIC)
trial reported a higher risk of mortality in the PPI arm with no
difference in gastrointestinal bleeding, detailed information on surgical
variables and clinically relevant surgical subgroups was not available.
<br/>METHOD(S): The analysis included all Canadian cardiac surgery
patients enrolled in the PEPTIC trial. Data were electronically linked
using unique patient identifiers to a clinical information system.
Outcomes of interest included in-hospital mortality, gastrointestinal
bleeding, Clostridium difficile infections, ventilator-associated
conditions and length of stay. <br/>RESULT(S): We studied 823 (50.6%)
randomized to PPIs and 805 (49.4%) to histamine-2-receptor blockers. In
the intention-to-treat analysis, there were no differences in hospital
mortality [PPI: 4.3% vs histamine-2 receptor blockers: 4.8%, adjusted odds
ratio (aOR) 0.97, 95% confidence interval (CI) 0.55-1.70],
gastrointestinal bleeding (3.9% vs 4.8%, aOR 1.09, 95% CI 0.66-1.81), C.
difficile infections (0.9% vs 0.1%, aOR 0.18, 95% CI 0.02-1.59),
ventilator-associated conditions (1.6% vs 1.7%, aOR 0.92, 95% CI
0.85-1.00) or median length of stay (9.2 vs 9.8 days, adjusted risk ratio
1.06, 85% CI 0.99-1.13). No significant treatment differences were
observed among subgroups of interest or per-protocol populations.
<br/>CONCLUSION(S): In a secondary analysis of cardiac surgery patients
enrolled in the PEPTIC trial in Canada, no differences in effectiveness or
safety were observed between use of PPIs and histamine-2 receptor blockers
for stress ulcer prophylaxis. CLINICAL TRIAL REGISTRATION NUMBER:
anzctr.org.au identifier: ACTRN12616000481471.<br/>Copyright &#xa9; The
Author(s) 2022. Published by Oxford University Press on behalf of the
European Association for Cardio-Thoracic Surgery. All rights reserved.

<78>
Accession Number
2019495371
Title
Distal Radial Artery Access in comparison to Forearm Radial Artery Access
for Cardiac Catheterization: A Randomized Controlled Trial (DARFORA
Trial).
Source
Journal of Interventional Cardiology. 2022 (no pagination), 2022. Article
Number: 7698583. Date of Publication: 2022.
Author
Daralammouri Y.; Nazzal Z.; Mosleh Y.S.; Abdulhaq H.K.; Khayyat Z.Y.;
Hamshary Y.E.; Azamtta M.; Ghanim A.; Awwad F.; Majadla S.; Maree M.;
Hamaida J.; Ismail Y.
Institution
(Daralammouri, Mosleh, Abdulhaq, Khayyat, Hamshary, Azamtta, Ghanim,
Awwad, Majadla, Maree, Hamaida, Ismail) Department of Medicine, Faculty of
Medicine and Health Sciences, An-Najah National University, Nablus,
Palestine
(Daralammouri, Azamtta, Majadla, Ismail) Department of Cardiology,
An-Najah National University Hospital, Nablus, Palestine
(Nazzal) Department of Family and Community Medicine, Faculty of Medicine
and Health Sciences, An-Najah National University, Nablus, Palestine
(Hamshary) Department of Internal Medicine, An-Najah National University
Hospital, Nablus, Palestine
(Ghanim, Maree, Hamaida) Department of Radiology, An-Najah National
University Hospital, Nablus, Palestine
Publisher
Hindawi Limited
Abstract
Background. In our clinical practice, conventional radial access has been
employed routinely for coronary procedures. The distal radial artery (DRA)
access site has recently emerged as a novel technique in cardiac
procedures. Objectives. This study compares distal radial access to
standard forearm radial access (FRA) in terms of feasibility, outcomes,
and complications. Method. This prospective, randomized trial was
conducted at a single center. The patients were chosen from An-Najah
National University Hospital's catheterization laboratory between December
2019 and November 2020. A total of 209 patients were randomized into two
groups: DRA group (n = 104) and FRA group (n = 105). Results. Access was
successful in 98% of patients in both the groups. The DRA group had a
longer puncture duration and a higher number of attempts (duration: 56.6
+/- 61.1 s DRA vs. 20.0 +/- 18.4 s FRA, p<0.001, attempts: 1.9 +/- 1.3 DRA
vs. 1.2 +/- 0.60 FRA, p<0.001). Puncture-associated pain was greater in
the DRA group (4 +/- 2.2 DRA vs. 3 +/- 2.1 FRA, p=0.001). There were two
radial artery occlusions in the FRA group and none in the DRA group
(p=0.139). Percutaneous coronary intervention (PCI) was performed in 26%
of the DRA group and 37.1% of the FRA group. The DRA group had
significantly shorter procedure times (p=0.006), fluoroscopy times
(p=0.002), and hemostasis times (p=0.002). Over time, the learning curve
demonstrated improved puncture duration and a decrease in the number of
puncture attempts. Conclusions. DRA is a safe and practical alternative to
FRA for coronary angiography and intervention. The overtime learning curve
is expected to improve puncture-related outcomes. <br/>Copyright &#xa9;
2022 Yunis Daralammouri et al.

<79>
Accession Number
2017528766
Title
A Brazilian randomized study: Robotic-Assisted vs. Video-assisted lung
lobectomy Outcomes (BRAVO trial).
Source
Jornal Brasileiro de Pneumologia. 48(4) (no pagination), 2022. Article
Number: e20210464. Date of Publication: 2022.
Author
Terra R.M.; de Araujo P.H.X.N.; Lauricella L.L.; de Campos J.R.M.;
Trindade J.R.M.; Pego-Fernandes P.M.
Institution
(Terra, de Araujo, Lauricella, de Campos, Trindade, Pego-Fernandes)
Divisao de Cirurgia Toracica, Departamento de Cardiopneumologia, Hospital
das Clinicas, Faculdade de Medicina, Universidade de Sao Paulo, SP, Sao
Paulo, Brazil
Publisher
Sociedade Brasileira de Pneumologia e Tisiologia
Abstract
Objective: To compare 90-day morbidity in patients undergoing lung
lobectomy performed by either robotic-assisted thoracic surgery (RATS) or
video-assisted thoracic surgery (VATS). Intraoperative complications,
drainage time, length of hospital stay, postoperative pain, postoperative
quality of life, and readmissions within 90 days were also compared.
<br/>Method(s): This was a two-arm randomized clinical trial including
patients with lung lesions (primary lung cancer or lung metastasis) who
were candidates for lung lobectomy. Patients with comorbidities that
precluded surgical treatment were excluded. All patients followed the same
postoperative protocol. <br/>Result(s): The overall sample comprised 76
patients (39 in the VATS group and 37 in the RATS group). The two groups
were similar regarding gender, age, BMI, FEV<inf>1</inf> in % of
predicted, and comorbidities. Postoperative complications within 90 days
tended to be more common in the VATS group than in the RATS group, but the
difference was not significant (p = 0.12). However, when only major
complications were analyzed, this tendency disappeared (p = 0.58).
Regarding postoperative outcomes, the VATS group had a significantly
higher number of readmissions within 90 days than did the RATS group (p =
0.029). No significant differences were found regarding intraoperative
complications, drainage time, length of hospital stay, postoperative pain,
and postoperative quality of life. <br/>Conclusion(s): RATS and VATS
lobectomy had similar 90-day outcomes. However, RATS lobectomy was
associated with a significant reduction in the 90-day hospital readmission
rate. Larger studies are necessary to confirm such a finding.
(ClinicalTrials.gov identifier: NCT02292914
[http://www.clinicaltrials.gov/]).<br/>Copyright &#xa9; 2022 Sociedade
Brasileira de Pneumologia e Tisiologia.

<80>
Accession Number
638635165
Title
Clinical Outcomes of Revascularization with Percutaneous Coronary
Intervention Prior to Transcatheter Aortic Valve Replacement: A
Comprehensive Meta-Analysis.
Source
Current problems in cardiology. (pp 101339), 2022. Date of Publication:
28 Jul 2022.
Author
Altibi A.M.; Ghanem F.; Hammad F.; Patel J.; Song H.K.; Golwala H.; Zahr
F.E.; Rahmouni H.
Institution
(Altibi, Song, Golwala, Zahr, Rahmouni) Knight Cardiovascular Institute,
Oregon Health and Science University, Portland, OR
(Ghanem, Patel) Internal Medicine Department, East Tennessee State
University, Johnson City, TN, United States
(Hammad) Internal Medicine Department, St. Vincent Charity Medical Center,
Cleveland, OH, United States
Publisher
NLM (Medline)
Abstract
BACKGROUND: Prior studies on revascularization prior to transcatheter
aortic valve replacement (TAVR), in patients with significant coronary
artery disease (CAD), have reported mixed results. AIM: We sought to
perform a meta-analysis combining current evidence by investigating
outcomes of revascularization in patients who undergo TAVR with coexisting
CAD. <br/>METHOD(S): We searched literature for studies reporting on
outcomes following TAVR performed with versus without pre-TAVR PCI, for
coexisting CAD. Random-effect model was used to pool estimates of odds
ratios (ORs). <br/>RESULT(S): Twenty-four reports with 12,182 TAVR
patients were included: 22 observational and 2 clinical trials. 4,110
(33.7%) were in the pre-TAVR PCI group, 51.4% were females, and mean age
was 81.9 years. The 30-day mortality was 5.2% versus 5.0% in patients with
versus without pre-TAVR PCI, respectively [OR= 1.19 (95% CI: 0.91-1.55, p=
0.20)]. Pooled 1-year mortality was 18.1% versus 19.1% in patients with
versus without pre-TAVR PCI (OR= 1.12, 95% CI: 0.95-1.31, p= 0.61). There
was no significant difference between the groups for myocardial
infarction, stroke, acute kidney injury, pacemaker implantation, or
rehospitalization. Pre-TAVR PCI was associated with increased risk of
life-threatening bleeding at 30 days. <br/>CONCLUSION(S): Pre-TAVR
revascularization with PCI was not associated with improved 30-day or
1-year mortality; however, it was associated with increased risk of
life-threatening bleeding at 30-day post-TAVR. Our results do not support
routine revascularization with PCI prior to TAVR with coexisting CAD.
Future trials addressing anatomical complexity and symptom burden may help
better risk stratify patients who may benefit with pre-TAVR
revascularization.<br/>Copyright &#xa9; 2022. Published by Elsevier Inc.

<81>
Accession Number
638633440
Title
Anti-factor X Activity Levels with Continuous Intravenous Infusion and
Subcutaneous Administration of Enoxaparin after Coronary Artery Bypass
Grafting: a Randomized Clinical Trial.
Source
Acta anaesthesiologica Scandinavica. (no pagination), 2022. Date of
Publication: 30 Jul 2022.
Author
Parviainen M.K.; Vahtera A.; Anas N.; Tahtinen J.; Huhtala H.; Kuitunen
A.; Jarvela K.
Institution
(Parviainen, Jarvela) Tampere University Heart Hospital Tampere, Finland
(Vahtera, Anas, Tahtinen, Kuitunen) Tampere University Hospital, Tampere,
Finland
(Huhtala) Tampere University, Faculty of Social Sciences, Tampere, Finland
(Kuitunen) Tampere University, Faculty of Medicine and Health Sciences,
Tampere, Finland
(Jarvela) Finnish Cardiovascular Research Center Tampere, Tampere
University, Tampere, Finland
Publisher
NLM (Medline)
Abstract
BACKGROUND: Low-molecular-weight heparin enoxaparin is widely used in
pharmacological thromboprophylaxis after coronary artery bypass grafting
(CABG). The aim of this study was to compare anti-factor X activity
(anti-Xa) levels when the thromboprophylactic dose of enoxaparin was
provided after CABG, with two different administration routes: continuous
intravenous infusion (CIV) and subcutaneous bolus (SCB) injection. We
hypothesized that the current standard method of SCB administration might
lead to lower anti-Xa levels than recommended in other patient groups, due
to reduced bioavailability. <br/>METHOD(S): In this prospective,
randomized, controlled clinical trial, 40 patients scheduled for elective
CABG were randomized to receive 40 mg of enoxaparin per day either as CIV
or SCB for 72 h. Enoxaparin was initiated 6-10 h after CABG. Anti-Xa
levels were measured 12-14 times during the study period. The primary
outcome i.e. the maximum anti-Xa concentration over 0-24 h (Cmax0-24h ),
was calculated from these measured values. Secondary outcomes were
Cmax25-72h and the trough concentration of anti-Xa after 72 h of
enoxaparin initiation (C72h ). <br/>RESULT(S): Twenty patients were
randomized to the CIV-group and 19 to the SCB-group. The median anti-Xa
Cmax0-24h was significantly lower in the CIV-group than in the SCB-group:
0.15 [interquartile range (IQR) 0.13-0.19] IU/mL versus 0.25 (IQR
0.18-0.32) IU/mL, p <0.005. The median anti-Xa Cmax25-72h was 0.12 (IQR,
0.1-0.17) IU/mL versus 0.23 (IQR 0.19-0.31) IU/mL, respectively, p <0.005.
At 72 h, there was no difference between the groups in their anti-Xa
levels. <br/>CONCLUSION(S): In this low-risk CABG patient population, SCB
administration of a thromboprophylactic dose of enoxaparin provided
anti-Xa levels that are considered sufficient for thromboprophylaxis in
other patient groups. CIV administration resulted in lower anti-Xa levels
compared to the SCB route.<br/>Copyright This article is protected by
copyright. All rights reserved.

<82>
Accession Number
638632523
Title
Alcohol consumption and subclinical and clinical coronary heart disease: A
Mendelian randomization analysis.
Source
European journal of preventive cardiology. (no pagination), 2022. Date of
Publication: 30 Jul 2022.
Author
Hisamatsu T.; Miura K.; Tabara Y.; Sawayama Y.; Kadowaki T.; Kadota A.;
Torii S.; Kondo K.; Yano Y.; Fujiyoshi A.; Yamamoto T.; Nakagawa Y.; Horie
M.; Kimura T.; Okamura T.; Ueshima H.
Institution
(Hisamatsu, Miura, Tabara, Kadowaki, Kadota, Torii, Kondo, Yano,
Fujiyoshi, Okamura, Ueshima) Department of Public Health, Shiga University
of Medical Science, Otsu, Japan
(Hisamatsu) Department of Public Health, Okayama University Graduate
School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
(Miura, Yano, Ueshima) NCD Epidemiology Research Center, Shiga University
of Medical Science, Otsu, Japan
(Tabara) Shizuoka Graduate University of Public Health, Shizuoka, Japan
(Sawayama, Yamamoto, Nakagawa, Horie) Department of Cardiovascular
Medicine, Shiga University of Medical Science, Otsu, Japan
(Fujiyoshi) Department of Hygiene, Wakayama Medical University, Wakayama,
Japan
(Yamamoto) Division of Cardiology, Department of Internal Medicine, Kohka
Public Hospital, Japan
(Kimura) Department of Cardiovascular Medicine, Kyoto University Graduate
School of Medicine, Kyoto, Japan
(Okamura) Department of Preventive Medicine and Public Health, Keio
University School of Medicine, Tokyo, Japan
Publisher
NLM (Medline)
Abstract
AIMS: The potential effect of alcohol consumption on coronary heart
disease (CHD) remains unclear. We used the variant rs671 in the aldehyde
dehydrogenase 2 gene (ALDH2) as an instrument to investigate the causal
role of alcohol intake in subclinical and clinical CHD. <br/>METHOD(S): We
conducted two Mendelian randomization studies: a cross-sectional study of
coronary artery calcification (CAC) on computed tomography of 1029 healthy
men (mean age, 63.8 years) and a case-control study of 421 men with CHD
(acute coronary syndrome [ACS] or stable angina pectoris) who underwent
coronary revascularization and 842 age-matched male controls.
<br/>RESULT(S): In the CAC study, medians (25%tiles, 75%tiles) of alcohol
consumption by ALDH2-rs671 *2 homozygotes (n=86 [8.4%]), *1*2
heterozygotes (n=397 [38.5%]), and *1 homozygotes (n=546 [53.1%]) were 0.0
(0.0, 0.0), 28.0 (0.0, 129.0), and 224.0 (84.0, 350.0) g/week,
respectively. In age-adjusted Poisson regression with robust error
variance, compared with *2 homozygotes, relative risks for prevalent CAC
score >0, >=100, and >=300 in *1 homozygotes were 1.29 (95% confidence
interval, 1.06-1.57), 1.76 (1.05-2.96), and 1.81 (0.80-4.09),
respectively. In age-adjusted ordinal logistic regression for CAC
distributions, we observed higher odds among *1 homozygotes (odds ratio,
2.19 [1.39-3.46]) and even among *1*2 heterozygotes (1.77 [1.11-2.82])
compared with *2 homozygotes. In the case-control study, conditional
logistic regression revealed lower prevalence of *1 homozygotes among men
with CHD (odds ratio, 0.54 [0.35-0.82]), especially ACS (0.46
[0.27-0.77]), than controls. <br/>CONCLUSION(S): Our findings indicate a
positive association of alcohol consumption with CAC burden but an inverse
association with clinical CHD, especially ACS.<br/>Copyright &#xa9; The
Author(s) 2022. Published by Oxford University Press on behalf of European
Society of Cardiology. All rights reserved. For permissions, please
e-mail: journals.permissions@oup.com.